Surgical instrument comprising separate tissue securing and tissue cutting systems

ABSTRACT

A surgical instrument is disclosed which comprises a staple firing system and a tissue cutting system. In various instances, the instrument is configured to prevent the tissue cutting system from being operated before the staple firing system has been fully actuated. In certain instances, the instrument is configured to prevent the tissue cutting system from being operated before the staple firing system has been actuated to sufficiently deform the staples.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation application claiming priority under35 U.S.C. § 120 to U.S. patent application Ser. No. 14/813,259, entitledSURGICAL INSTRUMENT COMPRISING SEPARATE TISSUE SECURING AND TISSUECUTTING SYSTEMS, filed Jul. 30, 2015, now U.S. Patent ApplicationPublication No. 2017/0027572, the entire disclosure of which is herebyincorporated by reference herein.

BACKGROUND

The present invention relates to surgical instruments and, in variousembodiments, to surgical stapling and cutting instruments and staplecartridges for use therewith.

A stapling instrument can include a pair of cooperating elongate jawmembers, wherein each jaw member can be adapted to be inserted into apatient and positioned relative to tissue that is to be stapled and/orincised. In various embodiments, one of the jaw members can support astaple cartridge with at least two laterally spaced rows of staplescontained therein, and the other jaw member can support an anvil withstaple-forming pockets aligned with the rows of staples in the staplecartridge. Generally, the stapling instrument can further include apusher bar and a knife blade which are slidable relative to the jawmembers to sequentially eject the staples from the staple cartridge viacamming surfaces on the pusher bar and/or camming surfaces on a wedgesled that is pushed by the pusher bar. In at least one embodiment, thecamming surfaces can be configured to activate a plurality of stapledrivers carried by the cartridge and associated with the staples inorder to push the staples against the anvil and form laterally spacedrows of deformed staples in the tissue gripped between the jaw members.In at least one embodiment, the knife blade can trail the cammingsurfaces and cut the tissue along a line between the staple rows.

The foregoing discussion is intended only to illustrate various aspectsof the related art in the field of the invention at the time, and shouldnot be taken as a disavowal of claim scope.

BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows:

FIG. 1 is a perspective view of a surgical stapling instrument inaccordance with at least one embodiment;

FIG. 2 is a perspective view of the surgical stapling instrument of FIG.1 with components thereof removed for the purpose of illustration;

FIG. 3 is an exploded perspective view of a surgical stapling instrumentincluding a handle, a shaft, and an end effector in accordance with atleast one embodiment;

FIG. 4 is a partial cross-sectional elevational view of the handle ofFIG. 3 illustrated in an unclamped, unfired configuration;

FIG. 5 is a partial cross-sectional elevational view of the handle ofFIG. 3 illustrated in a clamped, unfired configuration;

FIG. 6 is a partial cross-sectional elevational view of the handle ofFIG. 3 illustrated in a clamped, partially-fired configuration;

FIG. 7 is a partial cross-sectional elevational view of the handle ofFIG. 3 illustrated in a clamped, fully-fired configuration;

FIG. 8 is a partial cross-sectional elevational view of the handle ofFIG. 3 prior to being returned back to an unclamped configuration;

FIG. 9 is an elevational view of a surgical stapling instrumentincluding a handle, a shaft, and an end effector in accordance with atleast one embodiment;

FIG. 10 is an exploded perspective view of a staple cartridge for usewith the surgical stapling instrument of FIG. 9;

FIG. 11 is a perspective view illustrating the staple cartridge of FIG.10 being assembled to the surgical stapling instrument of FIG. 9;

FIG. 12 is a cross-sectional view illustrating the staple cartridge ofFIG. 10 positioned in the end effector of the surgical instrument ofFIG. 9 and illustrating the end effector in a clamped configuration;

FIG. 13 is a cross-sectional view illustrating the staple cartridge ofFIG. 10 positioned in the end effector of the surgical instrument ofFIG. 9 and illustrating staple drivers of the end effector being movedinto a fired configuration by a firing system;

FIG. 14 is a cross-sectional view illustrating the staple cartridge ofFIG. 10 positioned in the end effector of the surgical instrument ofFIG. 9 and illustrating the staple drivers operably disengaged from thefiring system;

FIG. 15 is a cross-sectional view illustrating the staple cartridge ofFIG. 10 positioned in the end effector of the surgical instrument ofFIG. 9 and illustrating a cutting member being actuated by the firingsystem;

FIG. 16 is an exploded view of a surgical stapling instrument inaccordance with at least one embodiment illustrated with componentsremoved for the purpose of illustration;

FIG. 17 is a detail view of a progress indicator of the surgicalstapling instrument of FIG. 16;

FIG. 18 is a cross-sectional view of an end effector of a surgicalstapling instrument illustrated in a clamped, but unfired configuration;

FIG. 19 is a cross-sectional view of the end effector of FIG. 18illustrated in a staple firing mode;

FIG. 20 is a cross-sectional view of the end effector of FIG. 18illustrating a shift between its staple firing mode and a tissue cuttingmode;

FIG. 21 is a cross-sectional view of the end effector of FIG. 18illustrated in its tissue cutting mode;

FIG. 22 is an exploded view of a surgical stapling instrument inaccordance with at least one embodiment illustrated with componentsremoved for the purpose of illustration;

FIG. 23 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 22 illustrated in an unclamped, unfiredconfiguration;

FIG. 23A is a detail view of a transmission of the surgical staplinginstrument of FIG. 22;

FIG. 24 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 22 illustrated in a clamped configuration prior to afiring stroke;

FIG. 25 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 22 illustrated in a clamped configuration after thefiring stroke;

FIG. 26 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 22 illustrated in a clamped, fired configurationprior to a transection stroke;

FIG. 27 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 22 illustrated in a clamped, fired configurationafter the transection stroke;

FIG. 28 is a perspective view of a transmission of the surgical staplinginstrument of FIG. 22;

FIG. 28A is another perspective view of the transmission of FIG. 28;

FIG. 29 is an exploded view of a surgical stapling instrument inaccordance with at least one embodiment illustrated with componentsremoved for the purpose of illustration;

FIG. 30 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 29 illustrated in an unclamped, unfiredconfiguration;

FIG. 30A is a detail view of a transmission of the surgical staplinginstrument of FIG. 29 illustrated in a configuration which correspondsto the unclamped, unfired configuration depicted in FIG. 30;

FIG. 31 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 29 illustrated in a clamped, unfired configuration;

FIG. 31A is a detail view of the transmission of the surgical staplinginstrument of FIG. 29 illustrated in a configuration which correspondsto the clamped, unfired configuration depicted in FIG. 31;

FIG. 32 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 29 illustrated in a clamped configuration in whichstaples are being deployed from the surgical instrument;

FIG. 32A is a detail view of the transmission of the surgical staplinginstrument of FIG. 29 illustrated in a configuration which correspondsto the clamped, fired configuration depicted in FIG. 32;

FIG. 33 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 29 illustrated in a clamped configuration in whichtissue is being transected by the surgical instrument;

FIG. 33A is a detail view of the transmission of the surgical staplinginstrument of FIG. 29 illustrated in a configuration which correspondsto the clamped, fired configuration depicted in FIG. 33;

FIG. 34 is an exploded view of a surgical stapling instrument inaccordance with at least one embodiment illustrated with componentsremoved for the purpose of illustration;

FIG. 35 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 34 in an unclamped, unfired configuration;

FIG. 36 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 34 in a clamped configuration prior to a firingstroke;

FIG. 37 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 34 in a clamped, fired configuration prior to atransection stroke;

FIG. 38 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 34 in a clamped, fired configuration after thetransection stroke;

FIG. 39 is an exploded view of a surgical stapling instrument inaccordance with at least one embodiment illustrated with componentsremoved for the purpose of illustration;

FIG. 40 is a partial cross-sectional view of a handle of the surgicalstapling instrument of FIG. 39 illustrated in an unclampedconfiguration;

FIG. 41 is a partial cross-sectional view of the handle of FIG. 40illustrated in a tissue-stapling operating mode;

FIG. 42 is a partial cross-sectional view of the handle of FIG. 40illustrated in a fired configuration;

FIG. 43 is a partial cross-sectional view of the handle of FIG. 40illustrating the handle being switched between its tissue-staplingoperating mode and a tissue-transecting operating mode;

FIG. 44 is a partial cross-sectional view of the handle of FIG. 40 aftera tissue transection stroke;

FIG. 45 is a partial cross-sectional view of a surgical staplinginstrument in accordance with at least one embodiment including a staplefiring bar, a knife bar, and a lock configured to hold the firing bar inposition while the knife bar is advanced relative to the firing bar;

FIG. 46 illustrates the firing bar of FIG. 45 in a fired position andthe lock positioned behind the staple firing bar;

FIG. 47 illustrates the knife bar of FIG. 45 in a fired position;

FIG. 48 illustrates the lock of FIG. 45 disengaged from the staplefiring bar such that the firing bar can be retracted;

FIG. 49 is a partial cross-sectional view of a surgical staplinginstrument in accordance with at least one alternative embodimentcomprising a manually-releasable lock;

FIG. 50 is a partial cross-sectional view of a surgical staplinginstrument in accordance with at least one embodiment illustrated in anunclamped configuration;

FIG. 51 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 50 illustrated in a clamped configuration;

FIG. 52 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 50 illustrated in a staple-firing configuration;

FIG. 53 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 50 illustrated in a tissue-cutting configuration;

FIG. 54 is a partial perspective view of an end effector in accordancewith at least one embodiment configured to sequentially fire staples andincise tissue captured within the end effector illustrated withcomponents removed for the purpose of illustration;

FIG. 55 is a partial perspective view of the end effector of FIG. 54illustrated in a staple firing operating mode;

FIG. 56 is a partial perspective view of the end effector of FIG. 54illustrated in a tissue transection operating mode;

FIG. 57 is a partial cross-sectional perspective view of an end effectorin accordance with at least one embodiment;

FIG. 58 is a partial cross-sectional perspective view of the endeffector of FIG. 57 illustrated in a staple firing operating mode;

FIG. 59 is a partial perspective view of the end effector of FIG. 57illustrated in a tissue transection operating mode;

FIG. 60 is a partial cross-sectional view of a surgical staplinginstrument in accordance with at least one embodiment;

FIG. 61 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 60 illustrated in a staple firing operating mode;

FIG. 62 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 60 transitioning between the staple firing operatingmode and a tissue transecting operating mode;

FIG. 63 is a partial cross-sectional view of the surgical staplinginstrument of FIG. 60 in its tissue transecting operating mode;

FIG. 64 is a partial cross-sectional perspective view of a surgicalstapling instrument in accordance with at least one embodimentillustrated in a partially fired condition; and

FIG. 65 is a partial cross-sectional elevational view of the surgicalstapling instrument of FIG. 64 illustrated in a partially firedcondition.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Applicant of the present application owns the following patentapplications that were filed on Jul. 30, 2015 and which are each hereinincorporated by reference in their respective entireties:

-   -   U.S. patent application Ser. No. 14/813,242, entitled SURGICAL        INSTRUMENT COMPRISING SYSTEMS FOR ASSURING THE PROPER SEQUENTIAL        OPERATION OF THE SURGICAL INSTRUMENT, now U.S. Pat. No.        10,194,913;    -   U.S. patent application Ser. No. 14/813,266, entitled SURGICAL        INSTRUMENT COMPRISING SYSTEMS FOR PERMITTING THE OPTIONAL        TRANSECTION OF TISSUE, now U.S. Pat. No. 10,524,795; and    -   U.S. patent application Ser. No. 14/813,274, entitled SURGICAL        INSTRUMENT COMPRISING A SYSTEM FOR BYPASSING AN OPERATIONAL STEP        OF THE SURGICAL INSTRUMENT, now U.S. Pat. No. 10,420,558.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. Well-known operations, components, andelements have not been described in detail so as not to obscure theembodiments described in the specification. The reader will understandthat the embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes” or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes” or “contains” one or more features possesses those oneor more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” referring to the portion closest to the clinicianand the term “distal” referring to the portion located away from theclinician. It will be further appreciated that, for convenience andclarity, spatial terms such as “vertical”, “horizontal”, “up”, and“down” may be used herein with respect to the drawings. However,surgical instruments are used in many orientations and positions, andthese terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, thereader will readily appreciate that the various methods and devicesdisclosed herein can be used in numerous surgical procedures andapplications including, for example, in connection with open surgicalprocedures. As the present Detailed Description proceeds, the readerwill further appreciate that the various instruments disclosed hereincan be inserted into a body in any way, such as through a naturalorifice, through an incision or puncture hole formed in tissue, etc. Theworking portions or end effector portions of the instruments can beinserted directly into a patient's body or can be inserted through anaccess device that has a working channel through which the end effectorand elongated shaft of a surgical instrument can be advanced.

Certain previous surgical stapling instruments are disclosed in:

European Patent Application No. EP 795298, entitled LINEAR STAPLER WITHIMPROVED FIRING STROKE, which was filed on Mar. 12, 1997;

U.S. Pat. No. 5,605,272, entitled TRIGGER MECHANISM FOR SURGICALINSTRUMENTS, which issued on Feb. 25, 1997;

U.S. Pat. No. 5,697,543, entitled LINEAR STAPLER WITH IMPROVED FIRINGSTROKE, which issued on Dec. 16, 1997;

U.S. Patent Application Publication No. 2005/0246881, entitled METHODFOR MAKING A SURGICAL STAPLER, which published on Nov. 10, 2005;

U.S. Patent Application Publication No. 2007/0208359, entitled METHODFOR STAPLING TISSUE, which published on Sep. 6, 2007;

U.S. Pat. No. 4,527,724, entitled DISPOSABLE LINEAR SURGICAL STAPLINGINSTRUMENT, which issued on Jul. 9, 1985;

U.S. Pat. No. 5,137,198, entitled FAST CLOSURE DEVICE FOR LINEARSURGICAL STAPLING INSTRUMENT, which issued on Aug. 11, 1992; and

U.S. Pat. No. 5,405,073, entitled FLEXIBLE SUPPORT SHAFT ASSEMBLY, whichissued on Apr. 11, 1995, the entire disclosures of which areincorporated by reference herein.

A surgical stapling instrument 100 is disclosed in FIGS. 1 and 2. Theinstrument 100 comprises a handle 110, a shaft 140 extending from thehandle 110, and an end effector 150. The handle 110 comprises a housing111, a frame 114 extending through the shaft 140, a closure trigger 120,and a firing trigger 130. The operation of the closure trigger 120 movesthe end effector 150 between an open configuration (FIG. 1) and a closedconfiguration. Referring primarily to FIG. 2, the closure trigger 120 ispivotably mounted to the handle housing 111 about a pivot 121 andincludes a drive portion 122 which is rotated distally when the closuretrigger 120 is moved between an open position (FIG. 1) and a closedposition. The closure trigger 120 is part of a closure drive whichfurther includes links 123 and closure bars 126. The links 123 arerotatably pinned to the drive portion 122 of the closure trigger 120about a pin 124 and the links 123 are rotatably pinned to the closurebars 126 about a pin 125. When the drive portion 122 of the closuretrigger 120 is rotated distally, the drive portion 122 drives theclosure bars 126 to move a staple cartridge 160 of the end effector 150toward an anvil 170 of the end effector 150 in order to clamp tissuebetween the staple cartridge 160 and the anvil 170 during a closurestroke of the closure drive. The drive portion 122 comprises a lock slot127 defined therein which is configured to receive the distal end 117 ofa closure lock 112 when the closure trigger 120 reaches its fullyclamped position. The closure lock 112 is rotatably mounted to thehandle housing 111 about a pivot pin 113 and is biased against the driveportion 122 of the closure trigger 120 by a biasing member, such as aspring, for example.

The operation of the firing trigger 130 fires the staples removablystored in the staple cartridge 160 toward the anvil 170. Referringprimarily to FIG. 2, the firing trigger 130 is pivotably mounted to thehandle housing 111 about a pivot 131 and includes a drive portion whichis rotated distally when the firing trigger 130 is moved between anunactuated position (FIG. 1) and an actuated position. The firingtrigger 130 is part of a firing drive which further includes a firingbar 136 which is driven distally when the firing trigger 130 is movedtoward its actuated position. The firing drive also includes a stapledriver and a cutting member which are advanced distally by the firingbar 136 during a firing stroke of the firing drive. The frame 114, theclosure bars 126, and the firing bar 136 are surrounded, or at leastsubstantially surrounded by a shaft housing 144.

The handle 110 can further comprise a firing return spring configured toreturn the firing trigger 130 back to its unactuated position to resetthe firing system after the firing stroke has been completed and thefiring trigger 130 has been released by the clinician. Similarly, thehandle 110 can further comprise a closure return spring configured toreturn the closure trigger 120 back to its open position and reset theclosure system after the closure lock 112 has been depressed by theclinician to disengage the closure lock 112 from the lock slot 127.

With regard to the embodiment disclosed in FIGS. 1 and 2, the firingtrigger 130 is actuated to staple and incise the tissue clamped in theend effector 150 in a single stroke of the firing trigger 130. Moreover,the embodiment disclosed in FIGS. 1 and 2 does not provide the clinicianoperating the instrument with the ability to pause between the staplefiring and the tissue cutting functions of the firing system. Inaddition, the instrument does not provide the clinician with anyfeedback as to whether the instrument is performing the staple formingfunction or the tissue cutting function. Provided below are variousimprovements to this instrument.

A surgical stapling instrument 200 is illustrated in FIGS. 3-8 and issimilar to the instrument 100 and/or the other surgical instrumentsdisclosed herein in many respects. For instance, referring primarily toFIG. 4, the instrument 200 comprises a closure trigger 120 which, whenactuated, drives the closure bars 126 distally to close the end effectorof the instrument 200. The actuation of the closure trigger 120 also atleast partially advances a firing bar 236 of the firing system distallyto a pre-staged position in which a firing trigger 130 can then beactuated to fire the staples from a staple cartridge positioned in theend effector. The firing trigger 130 comprises a drive portion 132 whichis aligned with a proximal end 133 of the firing bar 236 once the firingbar 236 has been moved into its pre-staged position. At such point,referring now to FIG. 5, the firing trigger 130 can be actuated to movethe firing bar 236 distally and fire the staples from the staplecartridge. The actuation of the firing trigger 130 and the distaladvancement of the firing bar 236, however, are limited by a stop, orswitch, 280. The switch 280 stops the distal advancement of the firingbar 236 before the firing bar 236 transects the tissue captured withinthe end effector. In order to transect the tissue, the switch 280 isactuated to release the firing bar 236, as illustrated in FIG. 6, sothat the firing stroke of the firing actuator 130 can be completed, asillustrated in FIG. 7. In such a way, the firing of the staples and thetransection of the tissue can comprise separate and distinct operationalsteps of the instrument 200. In such instances, the clinician can choosewhen to cut the tissue and/or whether to cut the tissue.

As discussed above, and referring primarily to FIG. 5, the firing bar236 is stopped by the switch 280 during the distal advancement of thefiring bar 236. The firing bar 236 comprises a slot 285 defined thereinand the switch 280 is removably positioned in the slot 285. The switch280 is pivotably mounted to the handle housing 111 about a pivot pin 281and comprises a lock arm 282 which is positioned in the slot 285. Thefiring bar 236 can be advanced distally by the firing trigger 130 untilthe proximal end of the slot 285 contacts the lock arm 282. At suchpoint, further distal movement of the firing bar 236 is prevented by thelock arm 282. A spring 284 is positioned between the lock arm 282 andthe handle housing 111 to bias the lock arm 282 into the slot 285 andhold the lock arm 282 in position until the switch 280 is actuated, asillustrated in FIG. 6. When the switch 280 is actuated, the lock arm 282is rotated out of the slot 285 and the firing bar 236 can then beadvanced distally once again, as illustrated in FIG. 7. When the firingbar 236 is advanced toward the end of its firing stroke, the lock arm282 is no longer registered with the slot 285 and the spring 284 biasesthe lock arm 282 against the bottom surface of the firing bar 236. Whenthe firing bar 236 is retracted toward its unfired position after thetissue has been cut, the lock arm 282 can become aligned with the slot285 once again and the spring 284 can bias the lock arm 282 into theslot 285.

Further to the above, the staples are completely formed at the pointwhen the firing bar 236 is stopped by the switch 280. In such instances,the tissue can be completely secured by the staples before a cuttingportion of the firing bar 236 is advanced to cut the tissue. Alternativeembodiments are envisioned in which the staples are only partiallyformed when the firing bar 236 is stopped by the switch 280. In suchembodiments, the tissue is cut at the same time that the stapleformation is completed. In either event, a pause in the operation of theinstrument 200 after a first step is provided which requires theintervention of a clinician to selectively decide whether to perform asecond step even though both steps are performed by one actuation of atrigger. Stated another way, the switch 280 stops the firing trigger 130during its actuation stroke and the stopping function of the switch 280must be defeated before the actuation stroke can be completed. Theswitch 280 can be operated at a time deemed suitable by the clinician.In certain instances, the switch 280 could be operated right after theswitch 280 stops the firing bar 236 or, alternatively, after a period oftime. In some instances, the switch 280 can be operated prior tostopping the firing bar 236 thereby permitting the first and secondsteps to be selectively combined.

Further to the above, the clinician may or may not remove their handfrom the firing trigger 130 during the pause provided by the switch 280.In either event, it is desirable to prevent the firing bar 236 fromretracting suddenly and/or unintentionally. To this end, the instrument200 further comprises a lock 290 which is configured to releasably holdthe firing bar 236 in position. The lock 290 comprises a ratchet system;however, any suitable lock may be utilized. The lock 290 is rotatablymounted to the housing 111 about a pivot pin 291 and comprises a pawl292 extending therefrom which is configured to engage ratchet teeth 295defined in the firing bar 236. The lock 290 further comprises a proximalarm 293 and a spring 294 positioned intermediate the proximal arm 293and the housing 111 configured to bias pawl 292 into engagement with theteeth 295. When the pawl 292 is engaged with the teeth 295, the lock 290is configured to permit the firing bar 236 to move distally but preventthe firing bar 236 from moving proximally. The handle 210 of theinstrument 200 further comprises a switch 296 configured to engage theproximal arm 293 of the lock 290 and rotate the pawl 292 away from thefiring bar 236 and disengage the pawl 292 from the teeth 295. At suchpoint, the firing bar 236 can be retracted.

In order to retract the firing bar 236, the clinician can push theclosure lock 112 to disengage the closure lock 112 from the closuretrigger 120 and move the closure trigger 120 to its unactuated position(FIG. 4) and/or the handle 210 can include a return spring configured tobias the closure trigger 120 toward its unactuated position. In eitherevent, the movement of the closure trigger 120 toward its unactuatedposition can pull the links 123 proximally which can, in turn, pull theclosure bars 126 and the firing bar 236 proximally. More particularly,the pin 125 which connects the links 123 also extends throughlongitudinal apertures defined in the closure bars 126 and the firingbar 236, such as longitudinal aperture 129 defined in the firing bar236, for example, and, when the links 123 are pulled proximally by theclosure trigger 120, the pin 125 can contact the proximal end of theaperture 129, and the proximal end of the longitudinal apertures definedin the closure bars 126, and pulls the firing bar 236 and the closurebars 126 proximally. The proximal movement of the firing bar 236 canalso push the firing actuator 120 back to its unactuated position and/orthe firing actuator 120 can be returned to its unactuated position by areturn spring. In either event, the lock 290 can be reset by pushing theswitch 296 distally to permit the pawl 292 to be re-engaged with theteeth 295 once the firing bar 236 has been returned to its unactuatedposition.

Further to the above, the pawl 292 can be configured to generate audiblesounds, such as clicks, for example, as the teeth 295 of the firing bar236 slide under the pawl 292. Such audible sounds can provide feedbackto the surgeon that the firing bar 236 is moving distally. Such audiblesounds can also provide feedback to the surgeon regarding the speed ofthe firing bar 236, as sounds emitted at a faster pace would indicatethat the firing bar 236 is moving at a faster speed while sounds emittedat a lower pace would indicated that the firing bar 236 is moving at aslower speed.

A surgical stapling instrument 300 is illustrated in FIGS. 9-15 and issimilar to the instruments 100, 200, and/or the other surgicalinstruments disclosed herein, in many respects. The instrument 300comprises an end effector 350 including a staple cartridge 360 and ananvil 170. In use, tissue is positioned between the staple cartridge 360and the anvil 170 and then trapped in the end effector 350 by adeployable tissue pin 379. The tissue pin 379 is stored in the staplecartridge 360 in a pin cavity 378 and moved distally toward the anvil170. The tissue pin 379 can be pushed distally when the staple cartridge360 is moved into a closed position, as discussed in greater detailfurther below. The tissue pin 379 comprises lateral gripping members 377which are configured to permit the clinician to push the pin 379 towardthe anvil 170 and/or retract the pin 379 into the staple cartridge 360.The staple cartridge 360 comprises lateral slots 375 defined thereinconfigured to guide the longitudinal movement of the gripping members377 and the tissue pin 379. The movement of the tissue pin 379 islimited by the anvil 170 and a proximal end plate 376.

Referring primarily to FIG. 9, the instrument 300 further comprises aclosure trigger 120 which, when actuated, drives closure bars 126distally to close the end effector 350 of the instrument 300 and clampthe tissue between the staple cartridge 360 and the anvil 170. Theinstrument 300 also comprises a firing trigger 130 which, when actuated,pushes a firing bar 336 distally to eject the staples from the staplecartridge 360 positioned in the end effector 350. Referring to FIGS.10-15, the staple cartridge 360 comprises a cartridge body 361 includinga plurality of staple cavities 361 a, 361 b and a knife slot 366 definedtherein. The staple cavities 361 a are positioned on a first side of theknife slot 366 and the staple cavities 361 b are positioned on a secondside of the knife slot 366. Although not illustrated, staples are storedin the staple cavities 361 a, 361 b and are ejected from the staplecavities 361 a, 361 b when a staple driver 362 is moved toward the anvil170 by the firing bar 336. The staple driver 362 comprises a pluralityof staple supports, or cradles, 362 a configured to drive the staplesstored in the staple cavities 361 a and a plurality of staple supports,or cradles, 362 b configured to drive the staples stored in the staplecavities 361 b. The staple driver 362 further comprises longitudinalguides 368 a and 368 b which are configured to control and/or constrainthe movement of the staple driver 362 to a longitudinal path.

Further to the above, the staple cartridge 360 comprises a cuttingmember, or knife, 367 which is slidably positioned in the knife slot366. The staple driver 362 comprises a first knife latch 364 a and asecond knife latch 364 b which are configured to releasably hold theknife 366 and the staple driver 362 together, as described in greaterdetail below. The staple driver 362 comprises a first pivot joint 363 aand a second pivot joint 363 b. The first knife latch 364 a is rotatablypositioned in the first pivot joint 363 a and the second knife latch 364b is rotatably positioned in the second pivot joint 363 b. The firstknife latch 364 a and the second knife latch 364 b are rotatable betweena clamped position (FIGS. 12 and 13) in which they are engaged with theknife 367 and an unclamped position (FIGS. 14 and 15) in which they aredisengaged from the knife 367. When the first knife latch 364 a and thesecond knife latch 364 b are in their clamped position, the stapledriver 362 and the knife 367 move together. In use, the staple driver362 and the knife 367 are pushed distally by the firing bar 336 to movethe staples between an unfired position (FIG. 12) and a fired position(FIG. 13). As can be appreciated from FIG. 13, the cutting edge of theknife 367 does not emerge from the cartridge body 361 to cut the tissuecaptured between the cartridge body 361 and the anvil 170 when thestaple driver 362 is moved into its fired position. Instead, the knife367 is in a staged position below the deck surface of the cartridge body361.

As can be seen in FIGS. 12 and 13, the firing bar 336 contacts the firstknife latch 364 a and the second knife latch 364 b to push the stapledriver 362 distally. Referring to FIGS. 11-13, the first knife latch 364a is releasably engaged with a knife support 369 such that the motion ofthe staple driver 362 can be transferred to the knife 367. Morespecifically, the first knife latch 364 a comprises a ridge 365 apositioned in a recess 369 a defined in the knife support 369 and,similarly, the second knife latch 364 b comprises a ridge 365 bpositioned in a recess 369 b defined the knife support 369. The ridges365 a, 365 b are securely received within their respective recesses 369a, 369 b such that the driving force delivered by the firing bar 336 istransferred to the staple driver 362 and the knife 367 to deform thestaples against the anvil 170. The ridges 365 a, 365 b and the recesses369 a, 369 b are configured such that the ridges 365 a, 365 b remainengaged with the recesses 369 a, 369 b until a threshold force isreached wherein, at such point, the knife latches 364 a, 364 b displaceoutwardly away from the knife support 369, as illustrated in FIGS. 14and 15. The threshold force can comprise the force needed to fully formthe staples, for example. At such point, the firing bar 336 is no longeroperably engaged with the staple driver 362 and the firing bar 336 canmove distally relative to the staple driver 362. The firing bar 336 canthen contact the knife support 369 directly to drive the knife 367toward the anvil 170 and transect the tissue. As can be seen in FIG. 15,the knife 367 moves relative to the staple driver 362 after the stapledriver 362 has decoupled from the knife 367.

Further to the above, the firing system of the instrument 300 comprisestwo separate and distinct stages—a first, or staple-firing, stage and asecond, or tissue-cutting, stage. The operation of the knife latches 364a, 364 b define the boundary between the two stages. When the knifelatches 364 a, 364 b are clamped to the knife 367, the firing system isin its staple-firing state. When the knife latches 364 a, 364 b areunclamped from the knife 367, the firing system is in its tissue-cuttingstage. These two stages are separate and distinct and there is nooverlap between them; however, embodiments are envisioned in which atleast some overlap between the two stages could exist.

A surgical stapling instrument 400 is illustrated in FIGS. 16 and 17 andis similar to the instrument 100, 200, 300 and/or the other surgicalinstruments disclosed herein in many respects. For instance, theinstrument 400 comprises a handle 410 including a housing 411 which issimilar to the housing 111 in many respects. The instrument 400 furthercomprises closure bars 126 which, further to the above, move a staplecartridge toward an anvil to clamp tissue therebetween. As discussedabove, the closure trigger 120 is actuated to move the closure bars 126distally. As also discussed above, the closure trigger 120 also advancesthe firing bar 136 into a pre-staged position when the closure trigger120 is actuated. The firing trigger 130 can then be actuated to move thefiring bar 136 distally and fire the staples from the staple cartridgeand, subsequently, incise the tissue. Thus, it can be said that firingbar 136 is moved distally during all three operating states—the closureoperating state, the staple-firing operating state, and thetissue-incising operating state. The instrument 400 further comprises aprogress indicator which reveals the operating state of the instrument400, as discussed in greater detail below.

Further to the above, referring primarily to FIG. 17, the progressindicator comprises demarcations 418 on the firing bar 136. Thedemarcations 418 comprise projections extending laterally from thefiring bar 136; however, in various other instances, the demarcations418 could comprise indicia printed on the firing bar 136, for example.The progress indicator further comprises a progress bar 415 positionedin a window 414 defined in the handle housing 411. The progress bar 415comprises indicia 416 which corresponds to the three operating states ofthe instrument 400. For instance, the indicia 416 comprises a firstindicia “clamp” which corresponds to the tissue clamping operatingstate, a second indicia “staple” which corresponds to the staple-firingoperating state, and a third indicia “cut” which corresponds to thetissue-incising operating state. The progress bar 415 further comprisesthree lines 417 which correspond to the completion of operating states.In use, the demarcations 418 on the firing bar 136 are aligned with afirst line 417 when the closure stroke has been completed, asillustrated in FIG. 17, a second line 417 when the staples have beenfully fired, and a third line 417 when the cutting stroke has beencompleted. Stated another way, the demarcations 418 move distally alongthe progress bar 415 as the firing bar 136 advances distally to indicatethe progress of the firing bar 136. Such movements of the demarcations418 is observable by the operator of the surgical instrument 400 throughthe window 414 defined in the handle housing 411. In at least oneembodiment, the portion of the progress bar 415 associated with theclamping operating state can be a first color, such as green, forexample, the portion of the progress bar 415 associated with thestaple-firing operating state can be a second color, such as yellow, forexample, and the portion of the progress bar 415 associated with thetissue-incising operating state can be a third color, such as red, forexample. In alternative embodiments, the progress bar 415 can be mountedto the firing bar 136 and the demarcations 418 can extend from thehandle housing 411.

A surgical stapling instrument 500 is illustrated in FIGS. 18-21. Theinstrument 500 is similar to the instrument 100, 200, 300, and/or 400 inmany respects. The instrument 500 comprises an end effector 550comprising a staple cartridge 560 and an anvil 170. The staple cartridge560 comprises a cartridge body 561 including staple cavities 561 adefined therein. Staples are removably stored in the staple cavities 561a. The staple cartridge 560 further comprises a staple driver 562comprising pushers 562 a which are configured to move the staples towardthe anvil 170 and eject the staples from the staple cavities 561 a. Theinstrument 500 further comprises a firing bar 536 configured to push thestaple driver 562 distally toward the anvil 170. The staple driver 562comprises proximally-extending flanges 564 which are engaged by thefiring bar 536 as the firing bar 536 is advanced distally. When the endeffector 550 is in an unclamped, but unfired, configuration asillustrated in FIG. 18, the flanges 564 are positioned within a channel568 defined in the cartridge 561. In fact, the flanges 564 are flexed,or biased, inwardly by the sidewalls of the channel 568 and slide alongthe sidewalls as the staple driver 562 moves distally. The flanges 564are engaged with and held in their inwardly-flexed position by thechannel sidewalls throughout the firing stroke of the staples. The endof the staple firing stroke is depicted in FIG. 19.

The staple cartridge 560 further comprises a cutting member 567 movablypositioned in a knife slot 566 defined in the cartridge body 561. Thecutting member 567 comprises a base 569 which is gripped between theflanges 564 such that, as the staple driver 562 is driven distally bythe firing bar 563, the cutting member 567 moves with the staple driver562. Referring again to FIG. 19 which depicts the end of the staplefiring stroke, it should be appreciated that the cutting member 567 hasnot yet emerged from the cartridge body 561. Thus, the staple firingoperation of the instrument 500 is separate and distinct from the tissueincising operation of the instrument 500. The instrument 500 transitionsbetween its staple firing operation and its tissue incising operationwhen the flanges 564 release the cutting member 567. Upon comparingFIGS. 19 and 20, is should be appreciated that the flanges 564 springoutwardly when the proximal ends of the flanges 564 are no longer biasedinwardly by the sidewalls of the channel 568. More specially, theflanges 564 flex outwardly once they clear the distal end 565 of thechannel 568. At such point, the flanges 564 are no longer engaged withthe cutting member 567. Moreover, at such point, the flanges 564 are nolonger engaged with the firing bar 536 and, as a result, the firing bar536 can no longer push the staple driver 562 distally. Instead, thefiring bar 536 can come into direct contact with the base 569 of thecutting member 567 and advance the cutting member 567 distally when thefiring bar 536 is advanced distally, as illustrated in FIG. 21, totransect the tissue captured between the anvil 170 and the staplecartridge 560.

Further to the above, the point in which the instrument 500 shiftsbetween a staple-firing operating mode and a tissue-cutting operatingmode is a function of the distance in which the firing bar 536 hasmoved. Other instruments disclosed herein shift between a staple-firingoperating mode and a tissue-cutting operating mode as a function of theforce transmitted through a firing bar of the instrument, for example.Certain embodiments could employ a combination of both shiftingapproaches.

A surgical stapling instrument 600 is illustrated in FIGS. 22-28A. Theinstrument 600 is similar to the instruments 100, 200, 300, 400, 500and/or the other surgical instruments disclosed herein in many respects.The instrument 600 comprises a handle 610 which includes a closuretrigger 620 configured to operate a closure, or tissue clamping, systemand a firing trigger 630 configured to operate a firing system. Theclosure trigger 620 is rotatable between an unactuated position (FIG.24) and an actuated position (FIG. 25). The closure system of theinstrument 600 is similar to the closure system of the instrument 100 inmany respects and is not repeated herein for the sake of brevity. Invarious instances, the instrument 600 includes a lockout system whichprevents the actuation of the firing trigger 630 prior to the actuationof the closure trigger 620.

Further to the above, the closure trigger 620 comprises a drive portion622 which pushes the links 123 distally to clamp the end effector of thesurgical instrument 600 onto tissue. The drive portion 622 comprises aclearance slot 628 defined therein such that the drive portion 622 canmove relative to a shaft 634 which extends through the clearance slot628.

The firing system of the instrument 600 is separate and distinct fromthe closure system. The firing system has two separate and distinctoperating functions, i.e., a staple firing function and a tissueincising function. The staple firing function occurs during a firstactuation of the firing trigger 630 and the tissue incising functionoccurs during a second actuation of the firing trigger 630. Similar tothe above, the firing trigger 630 is rotatably coupled to the housing111 about a pivot 131. Referring primarily to FIGS. 23, 23A, 28, and28A, the firing trigger 630 comprises a gear portion 632 which ismeshingly engaged with a pinion gear 633. The pinion gear 633 is mountedto the shaft 634 which is rotatably mounted to the handle housing 111.More specifically, the pinion gear 633 is mounted to a first portion 634a of the shaft 634 such that the pinion gear 633 and the shaft portion634 a rotate together. Thus, the actuation, or rotation, of the firingtrigger 630 rotates the pinion gear 633 and the first shaft portion 634a.

Referring again to FIGS. 28 and 28A, the shaft 634 further comprises asecond portion 634 b which is selectively engageable with the firstportion 634 a at a ratchet interface 639. When the second shaft portion634 b is operably engaged with the first portion 634 a, the rotation ofthe first portion 634 a is transferred to the second portion 634 b andthe first and second shaft portions 634 a, 634 b rotate together. Anoutput pinion gear 635 is mounted to the second shaft portion 634 b suchthat the pinion gear 635 rotates with the second shaft portion 634 b.The pinion gear 635 is meshingly engaged with a rack 637 defined on theproximal end of a firing bar 636. In use, referring now to FIG. 25, theratchet interface 639 is configured to transfer the rotational motion ofthe firing trigger 630 to the firing bar 636 and drive the firing bar636 distally (direction D in FIG. 28) when the firing trigger 630 isactuated.

Further to the above, referring again to FIG. 25, a first actuation ofthe firing trigger 630 pushes the firing bar 636 distally to fire thestaples. After the first actuation, the surgeon can release the firingtrigger 630 and allow a return spring operably coupled with the firingtrigger 630 to return the firing trigger 630 back to its unfiredposition, as illustrated in FIG. 26. Alternatively, the surgeon canmanually return the firing trigger 630 back to its unactuated position.In either event, the ratchet interface 639 is configured to permit thefirst shaft portion 634 a to rotate relative to the second shaft portion634 b when the firing trigger 630 is returned to its unfired position.More specifically, the first shaft portion 634 a comprises ratchet teethwhich slide relative to corresponding ratchet teeth defined on thesecond shaft portion 634 b when the firing trigger 630 is returned toits unactuated position. In order to accommodate such relative movement,the first shaft portion 634 a is permitted to displace away from thesecond shaft portion 634 b. The handle 610 further comprises a biasingmember, such as a spring, for example, configured to re-engage the firstshaft portion 634 a with the second shaft portion 634 b once the firingtrigger 630 has been returned to its unactuated position.

Referring again to FIG. 26, the reader should appreciate that the firingbar 636 has been only partially advanced during the first stroke of thefiring trigger 630. Such partial advancement of the firing bar 630during the first stroke of the firing trigger 630 fires, or completelyforms, the staples stored within the end effector of the instrument 600,but it does not transect the tissue captured within the end effector.Referring now to FIG. 27, the firing trigger 630 can be actuated asecond time to fully advance the firing bar 630 and transect the tissue.As outlined above, the actuation, or rotation, of the firing trigger 630drives the pinion gear 633, the shaft 634, and the output pinion gear635 to advance the firing bar 636 distally. In various instances, thesurgeon may opt to not transect the tissue and may instead to unclampthe tissue after firing the staples. In such instances, the surgeonwould not actuate the firing trigger 630 a second time. In variousinstances, the teachings described above in connection with theinstrument 600 can be used in connection with the instruments 400 and/or500, for example.

A surgical stapling instrument 700 is illustrated in FIGS. 29-33A. Theinstrument 700 is similar to the instrument 100, 200, 300, 400, 500,600, and/or the other surgical instruments disclosed herein in manyrespects. The instrument 700 comprises a handle 710 which includes aclosure trigger 620 configured to operate a closure, or tissue clamping,system and a firing trigger 630 configured to operate a firing system.The closure trigger 620 is rotatable between an unactuated position(FIG. 30) and an actuated position (FIG. 31). The closure system of theinstrument 700 is similar to the closure system of the instrument 100 inmany respects and is not repeated herein for the sake of brevity. Invarious instances, the instrument 700 includes a lockout system whichprevents the actuation of the firing trigger 630 prior to the actuationof the closure trigger 620.

The firing system of the instrument 700 is separate and distinct fromthe closure system. The firing system has two separate and distinctoperating functions, i.e., a staple firing function and a tissueincising function. As described in greater detail further below, anactuation of the firing trigger 630 performs both functions. The firingtrigger 630 is rotatably mounted to the handle 710 about a pivot 131 andincludes a gear portion 632. The teeth of the gear portion 632 aremeshingly engaged with a pinion gear 733 which is rotatably mounted inthe handle 710 about a shaft 734. The shaft 734 further comprises twocam lobes, i.e., a first cam lobe 735 a and a second cam lobe 735 b,mounted thereto. The first cam lobe 735 a is configured to engage andadvance a staple firing bar 736 a and the second cam lobe 735 b isconfigured to engage and advance a tissue cutting bar 736 b. The camlobes 735 a, 735 b are mounted to the shaft 734 such that they rotatewith the shaft 734.

Prior to the firing trigger 630 being actuated, referring to FIG. 31,the first cam lobe 735 a is aligned with a first cam surface 737 adefined on the proximal end of the staple firing bar 736 a and thesecond cam lobe 735 b is aligned with a second cam surface 737 b definedon the proximal end of the tissue cutting bar 736 b. The first cam lobe735 a and the second cam lobe 735 b are mounted to the shaft 734 in astaggered relationship. When the firing trigger 630 is in its unactuatedposition, as illustrated in FIG. 31, the first cam lobe 735 a ispositioned adjacent to the first cam surface 737 a and the second camlobe 735 b is spaced apart from the second cam surface 737 b.

Further to the above, the firing trigger 630 is actuated to drive thestaple firing bar 736 a and the tissue cutting bar 736 b during a singlestroke of the firing trigger 630. A first portion of the firing triggeractuation drives the staple firing bar 736 a distally and a secondportion of the firing trigger actuation drives the tissue cutting bar736 b distally. The first portion does not overlap with the secondportion of the firing trigger actuation. Stated another way, the staplefiring process has been completed before the tissue cutting processbegins. In use, a ramp 738 a of the first cam lobe 735 a displaces thestaple firing bar 736 a distally until the ramp 738 a passes by thefirst cam surface 737 a. At such point, a dwell 739 a of the first camlobe 735 a is aligned with the first cam surface 737 a and the staplefiring bar 736 a is no longer advanced distally by the first cam lobe735 a. In various other embodiments, the dwell 739 a of the first camlobe 735 a can complete the staple-forming process. In such instances,the ramp 738 a of the first cam lobe 735 a initiates the staple formingprocess and the dwell 739 a finishes the staple forming process. In atleast one instance, the ramp 738 a can complete more of the stapleforming process than the dwell 739 a. In such instances, the staplesquickly grasp the tissue and are then slowly closed to fully secure thetissue therein. Alternatively, the dwell 739 a can complete more of thestaple forming process than the ramp 738 a. In such instances, thesqueezing pressure applied by the staples may be applied over a longerperiod of time which can better permit fluids to flow out of the tissueduring the staple forming process. In either event, the second cam lobe735 b is spaced apart from the ramp 738 a by the dwell 739 a. As theshaft 734 is rotated by the firing actuator 630, as illustrated in FIGS.32 and 32A, the second cam lobe 735 b is rotated into contact with thesecond cam surface 737 b and the staple cutting process is completed, asillustrated in FIGS. 33 and 33A.

In various instances, further to the above, the instrument 700 caninclude a stop which demarcates the transition between the staple firingprocess and the tissue cutting process. The stop can impede or arrestthe movement of the firing actuator 630 after the staple firing bar 736a has been fully advanced and prior to the tissue cutting bar 736 bbeing advanced, for example. The handle 710 can include a stop releasewhich, once actuated, can permit the surgeon to complete the firingstroke of the firing actuator 630. Such an embodiment can permit asurgeon to elect whether to proceed with the tissue cutting function ofthe instrument 700. In certain instances, the instrument 700 cangenerate haptic feedback, such as audible and/or tactile feedback, forexample, as the firing actuator 630 passes through the transitionbetween the staple firing function and the tissue cutting function.

In various alternative embodiments, further to the above, the tissuecutting process can at least partially overlap the staple formingprocess. In such embodiments, the first cam lobe 735 a and the secondcam lobe 735 b are positioned and arranged on the shaft 734 such thatthe first cam lobe 735 a can drive the staple firing bar 736 a at thesame time that the second cam lobe 735 b drives the tissue cutting bar736 b.

Further to the above, the firing actuator 630 can be returned to itsunactuated position after it has been actuated to fire the staplesand/or incise the tissue. The handle 710 can comprise a return springengaged with the firing actuator 630 which is biased to return thefiring actuator 630 to its unactuated position. In addition to or inlieu of the above, the instrument 700 can include one or more biasingmembers engaged with the bars 736 a, 736 b which are configured toreturn the bars 736 a, 736 b to their unfired position. As the firingactuator 630 is returned to its unactuated position, the gear portion632 rotates the pinion gear 733, the shaft 734, and the cam lobes 735 a,735 b in an opposite direction to disengage the cam lobes 735 a, 735 bfrom the bars 736 a, 736 b, respectively.

A surgical stapling instrument 800 is illustrated in FIGS. 34-38. Theinstrument 800 is similar to the instrument 100, 200, 300, 400, 500,600, and/or 700 in many respects and/or the other surgical instrumentsdisclosed herein. The instrument 800 comprises a handle 810 whichincludes a closure trigger 620 configured to operate a closure, ortissue clamping, system. The instrument 800 further comprises a firingtrigger 830 a configured to operate a staple firing system and a cuttingtrigger 830 b configured to operate a tissue cutting system. The closuretrigger 620 is rotatable between an unactuated position (FIG. 35) and anactuated position (FIG. 36). The closure system of the instrument 800 issimilar to the closure system of the instrument 100 in many respects andis not repeated herein for the sake of brevity. In various instances,the instrument 800 includes a lockout system which prevents theactuation of the firing trigger 830 a and/or the cutting trigger 830 bprior to the actuation of the closure trigger 620.

The firing system of the instrument 800 is separate and distinct fromthe closure system. An actuation of the firing trigger 830 a operatesthe staple firing system to deform staples removably stored in the endeffector of the instrument 800. The firing trigger 830 a is rotatablymounted to the handle 810 about a pivot 131 between an unfired position(FIG. 36) and a fired position (FIG. 37). The firing trigger 830 acomprises a curved cam member 832 a extending therefrom which is moveddistally when the firing trigger 830 a is actuated, as illustrated inFIG. 36. The cam member 832 a contacts a proximal end 837 a of a staplefiring bar 836 a when the cam member 832 a is advanced distally in orderto drive and deform the staples removably stored in the end effector ofthe instrument 800.

The cutting system of the instrument 800 is separate and distinct fromthe firing system and the closure system. An actuation of the cuttingtrigger 830 b operates the tissue cutting system to cut the tissuecaptured within the end effector of the instrument 800. The cuttingtrigger 830 b is rotatably mounted to the handle 810 about the pivot 131between an unactuated position (FIG. 37) and an actuated position (FIG.38). The cutting trigger 830 b comprises a curved cam member 832 bextending therefrom which is moved distally when the cutting trigger 830b is actuated, as illustrated in FIG. 38. The cam member 832 b contactsa proximal end 837 b of a tissue cutting bar 836 b when the cam member832 b is advanced distally in order to cut the tissue.

The firing actuator 830 a is rotated through a first range of motion tocomplete a firing stroke of the firing bar 836 a and the cuttingactuator 830 b is rotated through a second range of motion to complete acutting stroke of the cutting bar 836 b. The firing stroke is the samelength as, or at least substantially the same length as, the cuttingstroke; however, other embodiments are envisioned in which the length ofthe firing stroke is different than the length of the cutting stroke.Moreover, the first range of motion of the firing actuator 830 a is thesame as, or at least substantially the same as, the second range ofmotion of the cutting actuator 830 b; however, other embodiments areenvisioned in which the first range of motion is different than thesecond range of motion.

Referring again to FIGS. 37 and 38, the firing actuator 830 a comprisesa recess 839 defined therein. The recess 839 is configured to receive,or at least partially receive, the cutting actuator 830 b therein. Asillustrated in FIG. 36, the cutting actuator 830 b is nested with thefiring actuator 830 a when the firing actuator 830 a and the cuttingactuator 830 b are in their unactuated positions. When the firingactuator 830 a is moved into its actuated position, as illustrated inFIG. 37, the actuators 830 a, 830 b can become un-nested as the cuttingactuator 830 b can remain behind in its unactuated position. Thereafter,the actuation of the cutting actuator 830 b can re-nest the actuator 830b with the firing actuator 830 a, as illustrated in FIG. 38.

Further to the above, the separate and distinct actuators 830 a, 830 bcan permit the staple firing system and the tissue cutting system of theinstrument 800 to be selectively operated in a separate and distinctmanner. That said, a surgeon has the option of actuating the actuators830 a, 830 b of the instrument 800 simultaneously. In such instances,the instrument 800 will staple and cut the tissue captured in the endeffector simultaneously. Alternatively, in at least one embodiment, theinstrument 800 can include a lockout configured to prevent the cuttingactuator 830 b from being actuated prior to the complete actuation ofthe firing actuator 830 a. In such embodiments, the surgeon would nothave the option of actuating the actuators 830 a and 830 bsimultaneously, but still have the option of selectively actuating thecutting actuator 830 b. In a further alternative embodiment, the cuttingactuator 830 b could become unlocked at some point during the actuationof the firing actuator 830 a such that the actuators 830 a, 830 b couldbe thereafter actuated simultaneously, if desired by the surgeon. Suchan embodiment could assure that the staples have been at least partiallyfired, or at least sufficiently fired, prior to cutting the tissue.

A surgical stapling instrument 900 is illustrated in FIGS. 39-44. Theinstrument 900 is similar to the instrument 100, 200, 300, 400, 500,600, 700, 800, and/or the other surgical instruments disclosed herein inmany respects. The instrument 900 comprises a handle 910 including ahousing 911, a closure trigger 620 configured to operate a closure, ortissue clamping, system, and a firing trigger 930 a configured tooperate, one, a staple firing system and, two, a tissue cutting system.The closure trigger 620 is rotatable between an unactuated position(FIG. 40) and an actuated position (FIG. 41). The closure system of theinstrument 900 is similar to the closure system of the instrument 100 inmany respects and is not repeated herein for the sake of brevity. Invarious instances, the instrument 900 includes a lockout system whichprevents the actuation of the firing trigger 930 prior to the actuationof the closure trigger 620.

Further to the above, the firing trigger 930 is rotatably mounted to thehandle housing 911 about a pivot 131 between an unactuated position(FIG. 41) and an actuated position (FIG. 42). As described in greaterdetail below, the firing trigger 930 operates the staple firing systemduring a first actuation of the firing trigger 930 (FIG. 42) and thetissue cutting system during a second actuation of the firing trigger930 (FIG. 43). The firing trigger 930 comprises a curved cam portion 932which moves distally when the firing trigger 930 is actuated. The camportion 932 contacts a cam plate 985 when the cam portion 932 is rotateddistally. The cam plate 985 is slidably mounted in the handle housing911. The cam plate 985 is slidable longitudinally when it is pusheddistally by the cam portion 932. The cam plate 985 comprises a driveslot defined between arms 986, 987 extending from the distal end of thecam plate 985. The drive slot is configured to receive a proximal end ofa staple firing bar 936 a such that, when the cam plate 985 is pusheddistally, the cam plate 985 drives the firing bar 936 a distally to firethe staples removably stored within the end effector of the instrument900. More specifically, the distally-extending arm 986 contacts aproximal end 987 a of the staple firing bar 936 a to push the firing bar936 a distally.

Further to the above, the cam plate 985 is also slidable laterally. Morespecifically, the cam plate 985 is slidable between a first position inwhich the cam plate 985 is operably engageable with the staple firingbar 936 a (FIGS. 41 and 42) and a second position in which the cam plate985 is operably engageable with a tissue cutting bar 936 b (FIGS. 43 and44). The handle 910 further comprises a pusher block 980 engaged withthe cam plate 985. The pusher block 980 comprises a push pin 981extending therefrom which extends through the handle housing 911. Thepusher block 980 can include another push pin 981 extending through thehandle housing 911 in an opposite direction. In any event, the user ofthe surgical instrument 900 can shift the pusher block 980 between itsfirst position and its second position by applying a force to one of thepush pins 981. When the pusher block 980 is in its second position, thetissue cutting bar 936 b is positioned in the drive slot defined betweenthe arms 986 and 987. At such point, the cam plate 985 is operablycoupled with the tissue cutting bar 936 b and a subsequent actuation ofthe firing trigger 930 will actuate the tissue cutting system.

In use, the instrument 900 is positioned in a patient and the endeffector of the instrument 900 is positioned relative to the tissue thatis to be treated. The closure trigger 620 is then actuated to clamp theend effector onto the tissue. At such point, the pusher block 980 ispositioned in its first position and is operably engaged with the staplefiring bar 936 a. An actuation of the firing trigger 930 then advancesthe staple firing bar 936 a distally; however, this actuation of thefiring trigger 930 does not advance the tissue cutting bar 936 b as thecam slide 985 is not engaged with the tissue cutting bar 936 b. Afterthe firing trigger 930 has been actuated, the firing trigger 930 can bereleased and returned to its unactuated position, as illustrated in FIG.43. Similar to the above, the handle 910 can include a return springconfigured to return the firing trigger 930 back to its unactuatedposition. As also illustrated in FIG. 43, the firing bar 936 a remainsin its fired position when the firing trigger 930 is returned to itsunactuated position. Turning now to FIG. 44, the pusher block 980 can bemoved into its second position to disengage the pusher block 980 fromthe staple firing bar 936 a and engage the pusher block 980 with thetissue cutting bar 936 b. An actuation of the firing trigger 930 canthen advance the tissue cutting bar 936 b distally to cut the tissue;however, the surgeon has the option of not cutting the tissue and canrelease the tissue from the end effector without actuating the firingtrigger 930 a second time. The handle 910 can include a releasemechanism configured to return the closure trigger 620 and the closuresystem back to their unfired positions. In any event, the instrument 900can include one or more return springs and/or return mechanisms forresetting the bars 936 a, 936 b to their unactuated positions. In atleast one instance, the bars 936 a, 936 b can be reset when the endeffector is re-opened.

As discussed above, the staple firing bar 936 a remains in its distal,fired position while the firing trigger 930 is re-actuated to drive thetissue cutting bar 936 b distally. In various instances, the firing bar936 a may remain in its fired position owing to frictional forcesbetween the firing bar 936 a and the frame of the instrument 900, forexample; however, such frictional forces may be overcome and the firingbar 936 a can be pushed proximally. In certain instances, turning now toFIG. 45, a staple firing bar and/or a tissue cutting bar can includemeans for affirmatively holding the bars in an actuated, or an at leastpartially actuated, position.

In at least one exemplary embodiment, further to the above, a surgicalinstrument 1000 comprises a handle 1010 including a handle housing 1011.The instrument 1000 further comprises a staple firing bar 1036 aconfigured to eject and deform staples removably stored in an endeffector of the instrument 1000 when the firing bar 1036 a is pusheddistally. The instrument 1000 also comprises a tissue cutting bar 1036 bconfigured to incise the tissue captured within the end effector of theinstrument 1000. The handle 1010 comprises a lock 1090, for example,which is configured to hold the firing bar 1036 a in position while thecutting bar 1036 b is being actuated. The lock 1090 comprises a firstend mounted the handle housing 1011 and a second, or cantilever, end1092 engaged with a rack 1093 a of the firing bar 1036 a. The rack 1093a comprises a longitudinal array of teeth which is configured to permitthe firing bar 1036 a to move distally relative to the lock 1090, asillustrated in FIG. 46, and prevent the firing bar 1036 a from movingproximally relative to the lock 1090 until the lock 1090 is releasedfrom the firing bar 1036 a.

Further to the above, the lock 1090 sequentially positions itself behindeach tooth of the rack 1093 a as the firing bar 1036 a passes by thelock 1090. In the event that the surgeon were to pause the advancementof the firing bar 1036 a at some point during the firing stroke of thefiring bar 1036 a, the lock 1090 can hold the firing bar 1036 a inposition until the firing stroke is resumed. After the staple firingstroke has been completed, the lock 1090 is positioned behind theproximal-most tooth of the firing bar 1036 a. At such point, the lock1090 is held in engagement with the firing bar 1036 a by the tissuecutting bar 1036 b. The cutting bar 1036 b comprises a rack 1093 bdefined thereon which, similar to the above, includes a longitudinalarray of teeth which is configured to permit the cutting bar 1036 b tomove distally relative to the lock 1090, as illustrated in FIG. 47, andprevent the cutting bar 1036 b from moving proximally relative to thelock 1090 until the cutting bar 1036 b has completed its cutting stroke,as illustrated in FIG. 48. At such point, the lock 1090 can slip off theends of the firing bar 1036 a and the cutting bar 1036 b and becomedisengaged from the bars 1036 a and 1036 b.

Further to the above, the lock 1090 is held in a flexed configuration bythe bars 1036 a and 1036 b such that the lock 1090 can resilientlyexpand and disengage itself from the bars 1036 a and 1036 b after theracks 1093 a and 1093 b have passed by the lock 1090. The rack 1093 a isdefined on a flexible cantilever 1094 a extending proximally from thefiring bar 1036 a and the rack 1093 b is defined on a flexiblecantilever 1094 b extending proximally from the cutting bar 1036 b. Theracks 1093 a and 1093 b are configured to co-operatively flex with thelock 1090. In any event, the bars 1036 a and 1036 b can be returned totheir unactuated positions after the lock 1090 has become disengagedfrom the racks 1093 a and 1093 b, respectively. In various instances,one or more return springs can be associated with the bars 1036 a and1036 b to return the bars 1036 a and 1036 b to their unactuatedpositions.

Turning now to FIG. 49, the instrument 1000 can include a resetactuator, such as actuator 1190, for example, which can disengage thelock 1090 from the firing bar 1036 a and/or the cutting bar 1036 b priorto the completion of the firing stroke and/or cutting stroke of theinstrument 1000. The actuator 1190 comprises a first end 1191 rotatablymounted to the handle housing via a pivot pin 1193 and, in addition, asecond end 1192 configured to engage the lock 1090. A push button 1194is operably engaged with the first end 1191 of the actuator 1190 and isconfigured to rotate the second end 1192 of the actuator 1190 intoengagement with the lock 1090, as illustrated in FIG. 49, when the pushbutton 1194 is depressed. In such instances, the actuator 1190 flexesthe second end 1092 of the lock 1090 away from the bars 1036 a and 1036b and disengages the lock 1090 from the racks 1093 a and 1093 b. At suchpoint, the bars 1036 a and 1036 b can be retracted to their unactuatedpositions. Such a release actuation system can allow to the instrument1000 to be quickly opened and unclamped from the tissue at any suitablepoint during the operation of the instrument 1000. The push button 1194can be depressed to release the lock 1090 during the firing stroke,after the firing stroke, during the cutting stroke, and/or after thecutting stroke.

Referring to FIGS. 50-53, a surgical instrument 1200 comprises an endeffector 1250 and a closure system configured to close the end effector1250. The end effector 1250 comprises a staple cartridge 1260 and ananvil 170. The staple cartridge 1260 comprises a cartridge body 161, aplurality of staple cavities defined in the cartridge body, and staplesremovably stored in the staple cavities. The staple cartridge 1260 ismovable toward the anvil 170 between an open position (FIG. 50) and aclosed position (FIG. 51) to compress tissue between the cartridge body161 and the anvil 170. The instrument 1200 further comprises a closurebar 126 mounted to the cartridge body 161. The closure bar 126 can beadvanced distally to move the staple cartridge 1260 distally andretracted proximally to move the staple cartridge 1260 proximally. Theend effector 1250 further comprises a guide rail 168 configured to guidethe staple cartridge 1260 along a longitudinal axis as the staplecartridge 1260 is moved proximally and distally.

Referring primarily to FIGS. 50 and 51, the distal advancement of theclosure bar 126 also advances a tissue pin 379 distally to capturetissue within the end effector 1250. More specifically, the closure bar126 comprises a drive pin 128 a extending laterally therefrom which isconfigured to engage one or more tissue pin actuators 372 as the closurebar 126 is moved distally. The tissue pin actuators 372 are rotatablymounted to the shaft frame 114 about a pivot pin 118 and are movablebetween an unactuated position (FIG. 50) and an actuated position (FIG.51). Each tissue pin actuator 372 comprises a drive portion 373configured to engage and push a base 374 of the tissue pin 379. Thetissue pin 379 is slidably retained in a cavity 378 defined in the endeffector 1250 such that the movement of the tissue pin 379 isconstrained to a longitudinal path. The anvil 170 includes a pinaperture 179 defined therein which is configured to receive the tissuepin 379 when the tissue pin 379 has reached its fully-deployed position.

Further to the above, the staple cartridge 1260 moves toward the anvil170 before the tissue pin 379 is deployed. In such instances, the tissueis consecutively clamped and then trapped within the end effector 1250;however, alternative embodiments are envisioned in which the tissue isconcurrently clamped by the cartridge 1260 and trapped within the endeffector 1250 by the tissue pin 379. Other embodiments are envisioned inwhich the tissue pin 379 is deployed before the staple cartridge 1260 ismoved distally to compress the tissue.

Further to the above, the staple cartridge 1260 further comprises stapledrivers 162 configured to drive the staples toward the anvil 170. Theanvil 170 includes forming pockets 171 defined therein which areconfigured to deform the staples. As described in greater detail below,the staple drivers 162 are pushed distally by a firing bar 1236.Referring again to FIGS. 50 and 51, the closure bar 126 furthercomprises a second drive pin 128 b extending laterally therefrom whichis configured to engage the firing bar 1236 and move the firing bar 1236distally with the cartridge 1260 when the cartridge 1260 is moveddistally to clamp the tissue. In this way, the relative position of thefiring bar 1236 and the staple cartridge 1260 can be maintained, or atleast substantially maintained, during the closure of the end effector1250.

The firing bar 1236 does not push directly on the staple drivers 162;rather, the firing bar 1236 pushes directly on an intermediate driver1263 which transfers the movement of the firing bar 1236 to the stapledrivers 162. More specifically, the intermediate driver 1263 comprises aplurality of drive arms 1264 extending distally therefrom which are incontact with a drive surface 1265 defined on the proximal side of thestaple drivers 162. When the firing bar 1236 is being advanced distallyto deform the staples against the anvil 170, as illustrated in FIG. 52,the drive arms 1264 transmit force between the firing bar 1236 and thestaple drivers 162.

Each of the drive arms 1264 is rotatably connected to the intermediatedriver 1263 about a pivot pin 1266. Each drive arm 1264 is configuredand arranged such that it can transmit a certain amount of force to thestaple drivers 162 and, when the force transmitted through the drivearms 1264 exceeds a threshold force, the drive arms 1264 can rotate intoa collapsed position, as illustrated in FIG. 53. The threshold force isselected such that it coincides with the force necessary to deform thestaples into their formed, or fired, configurations; however, it isunderstood that a range of forces may be suitable to deform the staplesto a suitable formed height and the threshold force can be anywhere inthis suitable range or greater than this range. In any event, thecollapse of the drive arms 1264 allows the intermediate driver 1263 tomove relative to, or toward, the staple drivers 162 and, at such point,the staple drivers 162 may no longer move toward the anvil 170.Moreover, at such point, the staple firing process is complete and therelative motion now possible between the intermediate driver 1263 andthe staple drivers 162 is utilized to deploy a cutting member, or knife,toward the anvil 170 to cut the tissue. The cutting stroke of the knifebegins when the drive arms 1264 begin to collapse and ends when thedrive arms 1264 contact a support surface 1239 defined on theintermediate driver 1263. As a result of the above, the tissue cuttingoperation is separate and distinct from the staple firing operation.Moreover, the staple firing operation and the tissue cutting operationoccur sequentially and without overlap. Such an arrangement prevents thetransection of the tissue prior to the staples being completely formed.

The reader should appreciate that the operator of the surgicalinstrument 1200 can retract the firing bar 1236 to its unfired positionat any point during the staple firing operation of the instrument 1200.More specifically, the firing bar 1236 can be returned proximally untilit comes into contact with the second drive pin 128 b of the closure bar126. The reader should also appreciate that the operator of the surgicalinstrument can open the end effector 1250 and move the staple cartridge1260 away from the anvil 170 at any point during the staple firingoperation of the instrument 1200. That said, the instrument 1200includes a lockout system configured to prevent the end effector 1250from being opened during the tissue cutting operation. Moreover, theknife member must be fully retracted by the firing bar 1236 before thetissue pin 379 can be retracted and/or the end effector 1250 can beopened. Such a lockout system is depicted in FIGS. 51-53.

Referring to FIG. 51, each drive arm 1264 of the staple firing systemcomprises a lock pin 1267 extending therefrom. Each lock pin 1267 ispositioned in a lock slot defined in the cartridge body 161, whereineach lock slot comprises a first portion 1268 and a second portion 1269.As discussed in greater detail below, the lock pins 1267 are positionedin the first portions 1268 during the staple forming operation and thesecond portions 1269 during the tissue cutting operation. During thestaple forming operation of the instrument 1200, the lock pins 1267slide distally within the first portions 1268 of the lock slots, asillustrated in FIG. 52. In fact, the lock pins 1267 can be movedproximally and distally within the first portions 1268, therebypermitting the firing bar 1236 to be selectively advanced and retractedduring the staple forming operation, as mentioned above. Moreover, suchmovement of the pins 1267 within the first portions 1268 permits thestaple cartridge 1261 to be selectively moved proximally away from theanvil 170 of the instrument 1200, as also mentioned above, in order toopen the end effector 1250. During the tissue cutting operation,however, the lock pins 1267 enter into the second portions 1269 of thelock slots. At such point, the sidewalls of the second portions 1269prevent the cartridge body 161 from being retracted relative to thefiring bar 1236. In this way, the staple cartridge 1260 is locked inplace when the cutting member is exposed, or is possibly exposed. Insuch instances, the end effector 1250 cannot be opened until the cuttingmember is retracted, or at least sufficiently retracted. The cuttingmember is retracted when the firing bar 1236 is pulled proximally. Asthe firing member 1236 is pulled proximally, the lock pins 1267 movefrom the second portions 1269 of the lock slots into the first portions1268 and unlock the cartridge body 161. At such point, the lock pin 379can be retracted and/or end effector 1250 can be opened.

An alternative embodiment of a tissue stapling and cutting mechanism ofa surgical instrument 1300 is illustrated in FIGS. 54-56. The instrument1300 comprises a staple cartridge jaw 1360 which comprises, one, aplurality of staple drivers 1362 configured to eject staples from thestaple cartridge 1360 to staple tissue and, two, a knife member 1367configured to incise the tissue. The staple drivers 1362 and the knifemember 1367 are deployed by a firing member 1336; however, as discussedbelow, the deployment of the staple drivers 1362 and the knife member1367 is staggered. The firing member 1336 comprises a rack of teeth 1369which is moved, or translated, distally in direction D to deploy thestaple drivers 1362 and the knife member 1367. The instrument 1300further comprises a gear train 1366 operably engaged, or meshed, withthe rack 1369 which includes a plurality of rotatable gears. The rack1369 and the gear train 1366 are configured to convert the translationalmotion of the firing member 1336 to rotational motion of the gear train1366.

The gear train 1366 includes first and second output gears 1368. Eachoutput gear 1368 is mounted to a shaft 1363 such that the shaft 1363 andthe gear 1368 rotate together. The gear train 1366 further comprisesstaple firing output cams 1364 a, 1364 b mounted to each of the shafts1363. In the illustrated embodiment, each shaft 1363 comprises first andsecond staple deploying cams 1364 a mounted thereto which rotate withthe shaft 1383. Each cam 1364 a comprises a contoured surface which isconfigured to engage a drive surface 1365 a defined on the bottom of thestaple drivers 1362. When the cams 1364 a are rotated by the shafts1363, the cam profiles are rotated between a first orientationassociated with the unfired position of the staple drivers 1362 (FIG.54) and a second orientation associated with the fired position of thestaple drivers 1362 (FIG. 55). The first orientation and the secondorientation are approximately 180 degrees apart, for example. Suchmovement of the cams 1364 a and the staple drivers 1362 constitutes thefiring stroke of the instrument 1300 and the peaks of the cams 1364 aare in contact with the drive surface 1365 a when the staple drivers1362 have reached the end of the firing stroke, as illustrated in FIG.55.

Further to the above, the instrument 1300 comprises four staple firingcams 1364 a; however, any suitable number of cams 1364 a could beutilized. The four staple firing cams 1364 a are positioned and arrangedrelative to the drive surface 1365 a to provide a balanced, orsymmetrical, firing load to the staple drivers 1362. Upon comparingFIGS. 54 and 55, the reader should appreciate that the staple firingcams 1364 a move the staple drivers 1362 relative to the knife member1367. The knife member 1367 is deployed independently of the stapledrivers 1362, as discussed below.

The gear train 1366 further comprises a tissue cutting output cam 1364 bmounted to each of the shafts 1363. The cams 1364 b are configured todeploy the knife member 1367. Similar to the above, the cams 1364 brotate between a first orientation (FIG. 54) and a second orientation(FIG. 55) during the staple firing process discussed above; however, thecams 1364 b do not push the staple drivers 1362 or the knife member 1367distally during this rotation. Referring now to FIG. 56, subsequentrotation of the shaft 1363 and the cams 1364 b place the cams 1364 binto engagement with a drive surface 1365 b of the knife member 1367which pushes the knife member 1367 distally to cut the stapled tissue.Such subsequent rotation also rotates the peaks of the staple firingcams 1364 a out of engagement with the drive surface 1365 a. In suchinstances, the staple drivers 1362 can float back into, or be permittedto retract back into, the staple cartridge 1360 as the tissue is beingcut.

As discussed above, the cams 1364 a and 1364 b are positioned andarranged on the shafts 1363 such that the staple firing operation andthe tissue cutting operation do not occur at the same time. In someinstances, the cams 1364 a and 1364 b can be arranged such that there isa lull between the staple firing and tissue cutting operations. In atleast one such instance, the cams 1364 a and/or cams 1364 b can includea dwell which create a pause between the staple firing operation and thetissue cutting operation. Such a pause can afford the surgeon anopportunity to stop the operation of the instrument 1300 between thestaple firing stroke and the tissue cutting stroke. In alternativeembodiments, the cams 1364 a and 1365 b can be positioned and arrangedon the shafts 1363 such there is an overlap between the staple firingoperation and the tissue cutting operation. Such an overlap permits afast actuation of the instrument.

An alternative embodiment of a tissue stapling and cutting mechanism ofa surgical instrument 1400 is illustrated in FIGS. 57-59. The instrument1400 comprises a staple cartridge jaw 1460 including a cartridge body1461, a plurality of staple drivers 1462 configured to eject staplesfrom the cartridge body 1461 to staple tissue and, a knife member 1467configured to incise the tissue. The staple drivers 1462 and the knifemember 1467 are deployed by a firing member 1436; however, as discussedbelow, the deployment of the staple drivers 1462 and the knife member1467 is staggered. The staple drivers 1462 and the knife member 1467move distally between a first, or unactuated, position (FIG. 57) and asecond position (FIG. 58) which corresponds to the end of the staplefiring process. The knife member 1467 is then movable relative to thestaple drivers 1462 into a third position, as illustrated in FIG. 59.

Further to the above, the firing member 1436 comprises a ramped drivesurface 1464 defined thereon. In use, the staple drivers 1462 and theknife member 1467 are pushed distally by the drive surface 1464 to firethe staples from the cartridge body 1461. More specifically, the drivesurface 1464 pushes the knife member 1467 distally which, in turn,pushes the staple drivers 1462 distally, at least during the staplefiring process. The knife member 1467 comprises rollers 1465 a and 1465b which are in contact with the ramp surface 1464. The rollers 1465 aand 1465 b are rotatably mounted to the knife member 1467 about drivepins 1469 a and 1469 b, respectively. The drive pins 1469 a and 1469 bare positioned within drive slots 1463 a and 1463 b, respectively,defined in a frame 1468 which connects the staple drivers 1462. Thedrive pins 1469 a, 1469 b are configured to bear against the distalsidewalls of the drive slots 1463 a, 1463 b, respectively, when theknife member 1467 is pushed distally by the firing member 1436. In thisway, a staple firing force is transmitted from the firing bar 1436 tothe staple drivers 1462 via the drive ramp 1464, the rollers 1465 a,1465 b, the drive pins 1469 a, 1469 b, and the drive slots 1463 a, 1463b. The distal movement of the staple drivers 1462 is limited by a stopsurface 1466 defined in the cartridge body 1461, for example. When thestaple driver frame 1468 contacts the stop surface 1466, referring toFIG. 58, the firing stroke of the instrument 1400 is complete. At suchpoint, only a portion of the cutting surface of the knife member 1467has emerged from the cartridge body 1461; however, the tissue has notyet been exposed to the cutting surface. More particularly, the jaw, oranvil, opposing the staple cartridge 1460 can include a cavity which isconfigured to receive the emerged portion of the cutting surface and, asa result, the possibility of the knife member 1467 cutting the tissue atthis point in the operation of the instrument 1400 is reduced.

As discussed above, the distal movement of the staple drivers 1462 andthe knife member 1467 is constrained by the stop surface 1466 at the endof the firing stroke and, as a result, additional distal, orlongitudinal, motion of the firing bar 1436 will no longer be translatedinto distal, or longitudinal, motion of the staple drivers 1462 and theknife member 1467. Instead, referring to FIG. 59, additional distalmovement of the firing bar 1436 is converted into lateral movement ofthe knife member 1467. More specifically, additional distal movement ofthe ramp surface 1464 generates a reaction force between the knifemember 1467 and the now static driver frame 1468 which displaces theknife member 1467 laterally along the descending ramp surface 1464. Thelateral movement of the knife member 1467 is facilitated by the rollers1465 a, 1465 b; however, the knife member 1467 could slide along thedrive ramp 1464 in reaction to the continued distal movement of thefiring member 1436 without the assistance of the rollers 1465 a, 1465 b.

Further to the above, the knife member 1467 cuts the stapled tissue asit moves laterally through the staple cartridge 1460. The knife member1467 is displaced along a cutting axis which is transverse to alongitudinal firing axis defined by the motion of the firing member1436. The cutting axis is orthogonal, or at least substantiallyorthogonal, to the firing axis; however, any suitable arrangement couldbe utilized. Also further to the above, the cutting stroke of the knifemember 1467 begins at the end of firing stroke of the drivers 1462;however, it is envisioned that a delay could be provided between thecutting stroke and the firing stroke.

Many of the surgical instruments disclosed herein utilize a singlefiring bar for actuating a staple deploying system and a tissue cuttingsystem. Such instruments can benefit from the use of auditory and/ortactile feedback which can communicate to the user of a surgicalinstrument certain information regarding the current operating state ofthe surgical instrument. In at least one example, a firing bar of asurgical instrument can include a first array of teeth and a secondarray of teeth which can slide relative to one or more clicking elementsin the handle of the surgical instrument. During the staple firingoperation of the surgical instrument, the interaction between the firstarray of teeth and a clicking element can generate clicking soundsand/or vibrations. The first array of teeth can be arranged on thefiring bar such that the feedback is generated near the end of thefiring stroke, for example. With such feedback, the surgeon can slow theprogression of the firing bar if they intend to at least pause theoperation of the surgical instrument between the staple firing operatingmode and the tissue cutting operating mode, for example. Alternatively,the surgeon can elect to not cut the tissue. The second array of teethcan be arranged on the cutting bar such that the feedback is generatednear the end of the cutting stroke, for example. In certain embodiments,an array of teeth can be arranged on the firing bar such that feedbackis generated between the staple firing operating mode and the tissuecutting operating mode. The feedback described above could also beutilized with instruments including a staple firing bar and a separatetissue cutting bar.

A surgical instrument 1500 is disclosed in FIGS. 61-64. The instrument1500 includes a shaft 1540 and a circular end effector 1550 which isutilized to staple and transect a lumen, for example. The end effector1550 comprises a staple cartridge 1560 including a circular cartridgebody 1561 and a plurality of staples removably stored in the cartridgebody 1561 in a circular array. The staple cartridge 1560 furthercomprises staple drivers 1562 configured to eject the staples from thecartridge body 1561. The staple drivers 1562 are also arranged in acircular array and are connected to a common drive frame; however, anysuitable arrangement could be utilized. For instance, the staple drivers1562 may be unconnected to each other. The end effector 1550 furthercomprises a circular anvil 1570 configured to compress a portion of thelumen against the cartridge body 1561. The anvil 1570 is attached to aclosure actuator 1526 which extends through the shaft 1540. The closureactuator 1526 is configured to move the anvil 1570 toward and away fromthe staple cartridge 1560 between clamped and unclamped positions. FIGS.61-64 all illustrate the anvil 1570 in a clamped position. The anvil1570 further comprises a circular array of forming pockets 1571configured to deform the staples as the staples are ejected from thestaple cartridge 1560.

The surgical instrument 1500 further comprises a cutting member 1567configured to incise the tissue captured between the anvil 1570 and thestaple cartridge 1560. In use, the staple drivers 1562 drive the staplesagainst the anvil 1570 during a staple forming process (FIG. 61) and thecutting member 1567 cuts the tissue during a tissue cutting process(FIG. 63). As discussed below, the staple forming process and the tissuecutting process occur sequentially and there is no overlap therebetween;however, embodiments are contemplated in which the staple formingprocess and the tissue cutting process could occur, or at leastpartially occur, simultaneously.

Further to the above, and referring primarily to FIG. 60, the stapledrivers 1562 and the cutting member 1567 are stored in an unactuatedposition in the end staple cartridge 1560 when the anvil 1570 is movedinto its clamped position. The staple drivers 1562 and the cuttingmember 1567 are then moved distally by a firing member 1536 during thestaple forming process to deform the staples, as illustrated in FIG. 61.More specifically, a distal end 1538 of the firing member 1536 engages awasher 1539 positioned intermediate the firing member 1536 and thedrivers 1562 and the cutting member 1567 which, in turn, engages thedrivers 1562 and the cutting member 1567. The firing stroke of thestaple drivers 1562 ends when the drivers 1562 contact the proximal sideof the cartridge body 1561. Notably, the cutting member 1567 does notemerge from the cartridge body 1561 during the staple forming process;rather, the cutting member 1567 remains positioned within the cartridgebody 1561 during the staple forming process even though it is movedtoward the anvil 1570.

Once the staple drivers 1562 have bottomed-out against the cartridgebody 1561, the surgeon can understand that the staple forming processhas been completed. At such point, the surgeon can then retract thefiring member 1536 and skip the tissue cutting step, if they so choose.Alternatively, the surgeon can apply a pushing force to the firingmember 1536 to break the washer 1539, as illustrated in FIG. 62. Thispushing force is greater than the force needed to fire the staples. As aresult, the surgeon will experience a noticeable increase in the forcerequired to advance the firing member 1536 beyond the end of the staplefiring stroke. To begin the tissue cutting stroke, the surgeon wouldhave to volitionally elect to increase the force that they are applyingto the firing member 1536 if the firing member 1536 is driven by amanually-operated actuator. The washer 1539 can be constructed such thatit can withstand a force up to a threshold force, wherein once thethreshold force has been met or exceeded, the distal end 1538 of thefiring member 1536 can push through the washer 1539.

In certain instances, further to the above, the washer 1539 can beconstructed such that it breaks-way, or fails suddenly, once thethreshold force applied to the washer 1539 has been met. In at least onesuch instance, the washer 1539 can comprise a weakened portion whichpromotes the failure of the washer 1539 in a prescribed area, such asannular groove 1537, for example. In some instances, the distal end 1538of the firing member 1536 can comprise a cutting portion which transectsthe washer 1539. In any event, the washer 1539 can act as a fuse whichmust fail before the cutting stroke can begin.

Once the washer 1539 is broken or transected, or has otherwise failed,referring to FIG. 63, the washer 1539 will comprise two separateportions—a first portion 1539 a which can be pushed distally by thefiring member 1536 and a second portion 1539 b which remains behind. Thegroove 1537 is intermediate the first portion 1539 a and the secondportion 1539 b of the washer 1539. The groove 1537 makes the washer 1539sufficiently frangible such that the washer 1539 breaks once theappropriate level of force has been applied to the washer 1539. In atleast one instance, the washer 1539 is comprised of plastic, forexample. The first washer portion 1539 a is pushed distally by thefiring member 1536 to move the cutting member 1567 distally to completethe cutting stroke of the instrument 1500.

In addition to or in lieu of the manually-operated actuator, theinstrument 1500 can include an electric motor configured to drive thefiring member 1536. Such a system could also utilize at least one sensorconfigured to detect the loads experienced by the firing member and, inaddition, a controller in communication with the load sensor and theelectric motor which can govern the operation of the electric motor inview of data received from the load sensor. Such a system couldrecognize that the staple drivers 1562 had bottomed out and, in responsethereto, pause the electric motor. Such a pause could allow the surgeonto choose whether or not to open the anvil 1570 after the staple firingprocess or instruct the controller to perform the tissue cuttingprocess. The instrument 1500 can include a first button, for example,which can be actuated by the surgeon to open the anvil 1570 and a secondbutton, for example, which can be actuated by the surgeon to perform thetissue cutting process.

Further to the above, each surgical instrument disclosed herein caninclude, or can be modified to include, one or more manually-operatedtriggers and/or one or more electric motors for operating theinstrument. Surgical instruments 100, 200, 300, 400, 500, 600, 700, 800,900, 1000, 1200, 1300, 1400, and 1500 can include a manually-operatedclosure system which transmits forces between a closure trigger and anend effector of the surgical instrument. For instance, the instrument100 includes a manually-operated closure system configured to transmitthe rotation of the closure trigger 120 to the end effector 150. Inalternative embodiments, any of the instruments disclosed herein caninclude an electric motor configured to operate the closure system ofthe instrument. Similar to the above, the instruments can furtherinclude a control system configured to operate the electric motor inresponse to one or more inputs from the surgeon and/or data receivedfrom one or more sensors of the instrument.

In addition to or in lieu of the above, surgical instruments 100, 200,300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 caninclude a manually-operated firing system which transmits forces betweena firing trigger and an end effector of the surgical instrument. Forinstance, the instrument 100 includes a manually-operated firing systemconfigured to transmit the rotation of the firing trigger 130 to the endeffector 150. In alternative embodiments, any of the instrumentsdisclosed herein can include an electric motor configured to operate thefiring system of the instrument. Similar to the above, the instrumentscan further include a control system configured to operate the electricmotor in response to one or more inputs from the surgeon and/or datareceived from one or more sensors of the instrument.

The reader should appreciate that the surgical instruments 100, 200,300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, and 1400 are oftenused during surgical techniques in which one or more large incisions aremade in a patient to provide access to a surgical site within thepatient. These surgical techniques are often referred to as “open”surgical techniques. The teachings provided herein are adaptable tosurgical techniques in which instruments are inserted through one ormore trocars, or cannulas, that provide access ports into the patientthrough smaller incisions, for example. Open surgical techniques oftenprovide a surgeon with a better view of the surgical site whilelaparoscopic surgical techniques often result in smaller scars on thepatient's body. The instrument 1500 is insertable through a naturalorifice, such as the anus, for example, of a patient. The teachingsprovided herein are adaptable to surgical techniques in whichinstruments are inserted trough one or more natural orifices of thepatient.

The reader should appreciate that the staples of the surgicalinstruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200,1300, 1400, and 1500 are deployed longitudinally, i.e., along, parallelto, or substantially parallel to, a longitudinal axis defined by theshaft of the surgical instrument. Other embodiments are envisioned inwhich the staples are deployed along one or more axes which aretransverse to the longitudinal axis. FIGS. 64 and 65 disclose one suchexemplary surgical instrument, i.e., surgical instrument 1600. Thesurgical instrument 1600 comprises a staple cartridge jaw 1660 and ananvil jaw 1670. The staple cartridge jaw 1660 and/or the anvil jaw 1670is movable to clamp tissue therebetween. The staple cartridge jaw 1660comprises a cartridge body 1661 including a plurality of staple cavitiesdefined therein. The cartridge jaw 1660 further comprises a plurality ofstaples 1669 removably stored in the staple cavities and a plurality ofstaple drivers 1662 configured to eject the staples 1669 from the staplecavities. The instrument 1600 further comprises a firing bar 1636 whichis movable distally to lift the staple drivers 1662 and staples 1669toward the anvil jaw 1670. The anvil jaw 1670 includes staple formingpockets 1671 which are configured to deform the staples 1669, asillustrated in FIGS. 64 and 65. The teachings provided herein areadaptable to the surgical instrument 1600, or the like.

A surgical stapling system can comprise a shaft and an end effectorextending from the shaft. The end effector comprises a first jaw and asecond jaw. The first jaw comprises a staple cartridge. The staplecartridge is insertable into and removable from the first jaw; however,other embodiments are envisioned in which a staple cartridge is notremovable from, or at least readily replaceable from, the first jaw. Thesecond jaw comprises an anvil configured to deform staples ejected fromthe staple cartridge. The second jaw is pivotable relative to the firstjaw about a closure axis; however, other embodiments are envisioned inwhich first jaw is pivotable, or movable, relative to the second jaw.The surgical stapling system further comprises an articulation jointconfigured to permit the end effector to be rotated, or articulated,relative to the shaft. The end effector is rotatable about anarticulation axis extending through the articulation joint. Otherembodiments are envisioned which do not include an articulation joint.

The staple cartridge comprises a cartridge body. The cartridge bodyincludes a proximal end, a distal end, and a deck extending between theproximal end and the distal end. In use, the staple cartridge ispositioned on a first side of the tissue to be stapled and the anvil ispositioned on a second side of the tissue. The anvil is moved toward thestaple cartridge to compress and clamp the tissue against the deck.Thereafter, staples removably stored in the cartridge body can bedeployed into the tissue. The cartridge body includes staple cavitiesdefined therein wherein staples are removably stored in the staplecavities. The staple cavities are arranged in six longitudinal rows.Three rows of staple cavities are positioned on a first side of alongitudinal slot and three rows of staple cavities are positioned on asecond side of the longitudinal slot. Other arrangements of staplecavities and staples may be possible.

The staples are supported by staple drivers in the cartridge body. Thedrivers are movable between a first, or unfired position, and a second,or fired, position to eject the staples from the staple cavities. Thedrivers are retained in the cartridge body by a retainer which extendsaround the bottom of the cartridge body and includes resilient membersconfigured to grip the cartridge body and hold the retainer to thecartridge body. The drivers are movable between their unfired positionsand their fired positions by a sled. The sled is movable between aproximal position adjacent the proximal end and a distal positionadjacent the distal end. The sled comprises a plurality of rampedsurfaces configured to slide under the drivers and lift the drivers, andthe staples supported thereon, toward the anvil.

Further to the above, the sled is moved distally by a firing member. Thefiring member is configured to contact the sled and push the sled towardthe distal end. The longitudinal slot defined in the cartridge body isconfigured to receive the firing member. The anvil also includes a slotconfigured to receive the firing member. The firing member furthercomprises a first cam which engages the first jaw and a second cam whichengages the second jaw. As the firing member is advanced distally, thefirst cam and the second cam can control the distance, or tissue gap,between the deck of the staple cartridge and the anvil. The firingmember also comprises a knife configured to incise the tissue capturedintermediate the staple cartridge and the anvil. It is desirable for theknife to be positioned at least partially proximal to the rampedsurfaces such that the staples are ejected ahead of the knife.

The surgical instrument systems described herein have been described inconnection with the deployment and deformation of staples; however, theembodiments described herein are not so limited. Various embodiments areenvisioned which deploy fasteners other than staples, such as clamps ortacks, for example. Moreover, various embodiments are envisioned whichutilize any suitable means for sealing tissue. For instance, an endeffector in accordance with various embodiments can comprise electrodesconfigured to heat and seal the tissue. Also, for instance, an endeffector in accordance with certain embodiments can apply vibrationalenergy to seal the tissue.

EXAMPLES

Example 1—A surgical stapler for treating the tissue of a patientcomprises a handle, a shaft extending from the handle, and an endeffector extending from the shaft, wherein the end effector isconfigurable in an open configuration and a closed configuration. Theend effector comprises a first jaw, a second jaw, wherein the second jawis movable toward the first jaw to place the end effector in the closedconfiguration, a cartridge body including staple cavities, staplesremovably stored in the staple cavities, and an anvil configured todeform the staples. The surgical stapler further comprises a closuresystem configured to move the second jaw toward the first jaw, a firingsystem comprising a firing driver configured to eject the staples fromthe staple cavities toward the anvil during a firing stroke and acutting member configured to cut the tissue during a cutting stroke andretract the cutting member during a retraction stroke, and means forpreventing the end effector from being returned to the openconfiguration until after the retraction stroke has been completed.Example 2—The surgical stapler of Example 1, wherein the means permitsthe end effector to be returned to the open configuration during thefiring stroke.Example 3—The surgical stapler of Examples 1 or 2, wherein the meanspermits the end effector to be returned to the open configuration afterthe firing stroke is completed and before the cutting stroke isinitiated.Example 4—The surgical stapler of Examples 1, 2, or 3, furthercomprising a tissue pin movable between an undeployed position and adeployed position, wherein the tissue pin is configured to trap thetissue within the end effector, and a tissue pin actuator configured toextend the tissue pin between the undeployed position and the deployedposition during a deployment stroke and withdraw the tissue pin towardthe undeployed position during a withdrawal stroke, wherein the meansprevents the tissue pin from being withdrawn toward the undeployedposition during the cutting stroke.Example 5—The surgical stapler of Examples 1, 2, or 3, furthercomprising a tissue pin movable between an undeployed position and adeployed position, wherein the tissue pin is configured to trap thetissue within the end effector, and a tissue pin actuator configured toextend the tissue pin between the undeployed position and the deployedposition during a deployment stroke and withdraw the tissue pin towardthe undeployed position during a withdrawal stroke, wherein the meansprevents the tissue pin from being withdrawn toward the undeployedposition during the firing stroke.Example 6—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft, wherein the end effector isconfigurable in an open configuration and a closed configuration. Theend effector comprises a first jaw, a second jaw, wherein the second jawis movable toward the first jaw to place the end effector in the closedconfiguration, a cartridge body including staple cavities, staplesremovably stored in the staple cavities, and an anvil configured todeform the staples. The surgical stapler further comprises a closuresystem configured to move the second jaw toward the first jaw, a firingsystem comprising a driver configured to eject the staples from thestaple cavities toward the anvil during a firing stroke, and a cuttingmember configured to cut the tissue during a cutting stroke, wherein thecutting member comprises a cutting edge which is exposed from thecartridge body during the cutting stroke, and means for preventing theclosure system from being returned to the open configuration while thecutting member is exposed.Example 7—The surgical stapler of Example 6, wherein the means permitsthe end effector to be returned to the open configuration during thefiring stroke.Example 8—The surgical stapler of Examples 6 or 7, wherein the meanspermits the end effector to be returned to the open configuration afterthe firing stroke is completed and before the cutting stroke isinitiated.Example 9—The surgical stapler of Examples 6, 7, or 8, wherein the meanspermits the end effector to be returned to the open configuration afterthe firing stroke is completed and before the cutting member is exposed.Example 10—The surgical stapler of Examples 6, 7, 8, or 9, furthercomprising a tissue pin movable between an undeployed position and adeployed position, wherein the tissue pin is configured to trap thetissue within the end effector, and a tissue pin actuator configured toextend the tissue pin between the undeployed position and the deployedposition during a deployment stroke and withdraw the tissue pin towardthe undeployed position during a withdrawal stroke, wherein the meansprevents the tissue pin from being withdrawn toward the undeployedposition while the cutting member is exposed.Example 11—The surgical stapler of Examples 6, 7, 8, or 9, furthercomprising a tissue pin movable between an undeployed position and adeployed position, wherein the tissue pin is configured to trap thetissue within the end effector, and a tissue pin actuator configured toextend the tissue pin between the undeployed position and the deployedposition during a deployment stroke and withdraw the tissue pin towardthe undeployed position during a withdrawal stroke, wherein the meansprevents the tissue pin from being withdrawn toward the undeployedposition during the firing stroke.Example 12—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft, wherein the end effector isconfigurable in an open configuration and a closed configuration. Theend effector comprises a first jaw, a second jaw, wherein the second jawis movable toward the first jaw to place the end effector in the closedconfiguration, a cartridge body including staple cavities, staplesremovably stored in the staple cavities, and an anvil configured todeform the staples. The surgical stapler further comprises a closuresystem configured to move the second jaw toward the first jaw, a firingsystem comprising a staple driver, wherein the firing system isconfigured to push the staple driver toward the anvil during a firingstroke and retract the staple driver during a retraction stroke, and acutting member configured to cut the tissue during a cutting stroke,wherein the cutting member comprises a cutting edge which is exposedfrom the cartridge body during the cutting stroke, and means forpreventing the staple driver from being retracted while the cuttingmember is exposed.Example 13—The surgical stapler of Example 12, wherein the means permitsthe end effector to be returned to the open configuration during thefiring stroke.Example 14—The surgical stapler of Examples 12 or 13, wherein the meanspermits the end effector to be returned to the open configuration afterthe firing stroke is completed and before the cutting stroke isinitiated.Example 15—The surgical stapler of Examples 12, 13, or 14, wherein themeans permits the end effector to be returned to the open configurationafter the firing stroke is completed and before the cutting member isexposed.Example 16—The surgical stapler of Examples 12, 13, 14, or 15 furthercomprising a tissue pin movable between an undeployed position and adeployed position, wherein the tissue pin is configured to trap thetissue within the end effector, and a tissue pin actuator configured toextend the tissue pin between the undeployed position and the deployedposition during a deployment stroke and withdraw the tissue pin towardthe undeployed position during a withdrawal stroke, wherein the meansprevents the tissue pin from being withdrawn toward the undeployedposition during the cutting stroke.Example 17—The surgical stapler of Examples 12, 13, 14, or 15, furthercomprising a tissue pin movable between an undeployed position and adeployed position, wherein the tissue pin is configured to trap thetissue within the end effector, and a tissue pin actuator configured toextend the tissue pin between the undeployed position and the deployedposition during a deployment stroke and withdraw the tissue pin towardthe undeployed position during a withdrawal stroke, wherein the meansprevents the tissue pin from being withdrawn toward the undeployedposition during the firing stroke.Example 18—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, an end effectorextending from the shaft, wherein the end effector is configurable in anopen configuration and a closed configuration. The end effectorcomprises a first jaw, a second jaw, wherein the second jaw is movabletoward the first jaw to place the end effector in the closedconfiguration, a cartridge body including staple cavities, staplesremovably stored in the staple cavities, an anvil configured to deformthe staples, and a tissue pin movable between an undeployed position anda deployed position, wherein the tissue pin is configured to trap thetissue within the end effector. The surgical stapler further comprises aclosure system configured to move the second jaw toward the first jaw, atissue pin actuator configured to move the tissue pin between theundeployed position and the deployed position during a deployment strokeand retract the tissue pin toward the undeployed position during aretraction stroke, a firing system comprising a staple driver, whereinthe firing system is configured to push the staple driver toward theanvil during a firing stroke, and a cutting member configured to cut thetissue during a cutting stroke, wherein the cutting member comprises acutting edge which is exposed from the cartridge body during the cuttingstroke, and means for preventing the tissue pin from being retractedwhile the cutting member is exposed.Example 19—The surgical stapler of Example 18, wherein the means permitsthe end effector to be returned to the open configuration during thefiring stroke.Example 20—The surgical stapler of Examples 18 or 19, wherein the meanspermits the end effector to be returned to the open configuration afterthe firing stroke is completed and before the cutting stroke isinitiated.Example 21—The surgical stapler of Examples 18, 19, or 20, wherein themeans permits the end effector to be returned to the open configurationafter the firing stroke is completed and before the cutting member isexposed.Example 22—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft comprising a first jaw, a second jaw,wherein one of the first jaw and the second jaw is movable relative tothe other of the first jaw, a cartridge body including staple cavities,staples removably stored in the staple cavities, and an anvil configuredto deform the staples. The surgical stapler further comprises a firingsystem configured to eject the staples from the staple cavities towardthe anvil during a firing stroke and cut the tissue during a cuttingstroke after the firing stroke has been completed.Example 23—The surgical stapler of Example 22, wherein the firing systemcomprises a firing bar, and wherein the firing bar is movable toward theend effector to perform the firing stroke and the cutting stroke.Example 24—The surgical stapler of Examples 22 or 23, further comprisinga stop configured to stop the firing bar after the firing stroke.Example 25—The surgical stapler of Example 24, wherein the stop ismanually-actuatable to release the firing member such that the firingmember can perform the cutting stroke.Example 26—The surgical stapler of Examples 22, 23, 24, or 25, whereinthe firing system further comprises a staple driver configured to ejectthe staples from the staple cavities, and a cutting member configured tocut the tissue, wherein the cutting member moves with the staple driverduring the firing stroke, and wherein the cutting member does not cutthe tissue during the firing stroke.Example 27—The surgical stapler of Example 26, wherein the cuttingmember is coupled to the staple driver during the firing stroke, andwherein the cutting member is uncoupled from the staple driver duringthe cutting stroke.Example 28—The surgical stapler of Examples 26 or 27, further comprisinga clamp which releasably holds the cutting member to the staple driverduring the firing stroke of the firing member, wherein the clamp isconfigured to release the cutting member from the staple driver when aforce transmitted through the firing member exceeds a threshold force.Example 29—The surgical stapler of Examples 26 or 27, further comprisinga clamp which releasably holds the staple driver to the cutting memberduring the firing stroke of the firing member, and a clamp restraintconfigured to releasably hold the clamp in a clamped state during thefiring stroke and allow the clamp to bias open to disengage the firingmember from the firing bar during the cutting stroke.Example 30—The surgical stapler of Examples 22, 23, 24, 25, 26, 27, 28,or 29, wherein the handle comprises a firing trigger operably coupledwith the firing member, wherein the firing trigger is rotatable througha first range of motion and a second range of motion, wherein the firingtrigger moves the firing member through the firing stroke when thefiring trigger is moved through the first range of motion, and whereinthe trigger moves the firing member through the cutting stroke when thefiring trigger is moved through the second range of motion.Example 31—The surgical stapler of Example 30, wherein the first rangeof motion is discrete with respect to the second range of motion.Example 32—The surgical stapler of Examples 30 or 31, wherein the firstrange of motion and the second range of motion occur during a singleactuation of the firing trigger.Example 33—The surgical stapler of Examples 22, 23, 24, 25, 26, 27, 28,29, 30, 31, or 32, further comprising an indicator configured to providea first indication when the firing stroke has been completed and asecond indication when the cutting stroke has been completed, andwherein the first indication is different than the second indication.Example 34—The surgical stapler of Example 33, wherein the firstindication comprises one of a visual indication, an auditory indication,and a haptic indication, and wherein the second indication comprises oneof a visual indication, an auditory indication, and a haptic indication.Example 35—The surgical stapler of Example 30, wherein the first rangeof motion occurs during one actuation of the firing trigger, and whereinthe second range of motion occurs during another actuation of the firingtrigger.Example 36—The surgical stapler of Example 30, further comprising anindicator configured to provide a first indication when the oneactuation of the firing trigger has been completed and a secondindication when the another actuation of the firing trigger has beencompleted, and wherein the first indication is different than the secondindication.Example 37—The surgical stapler of Examples 22, 23, 24, 25, 26, 27, 28,29, 30, 31, 32, 33, 34, 35, or 36, wherein the firing system comprises afiring bar configured to eject the staples from the staple cavitiesduring the firing stroke, and a knife bar configured to cut the tissueduring the cutting stroke.Example 38—The surgical stapler of Example 37, wherein the firing systemfurther comprises a firing trigger, wherein the firing bar is driventoward the end effector during an actuation of the firing trigger, andwherein the knife bar is driven toward the end effector during theactuation of the firing trigger.Example 39—The surgical stapler of Example 38, wherein the firingtrigger is shiftable between a first position in which the firingtrigger is operably engaged with the firing bar and a second position inwhich the firing trigger is operably engaged with the knife bar.Example 40—The surgical stapler of Examples 38 or 39, further comprisinga switching mechanism configured to automatically shift the firingtrigger out of engagement with the firing bar and into engagement withthe knife bar after the firing stroke.Example 41—The surgical stapler of Examples 38, 39, or 40, furthercomprising a switching mechanism configured to permit the firing triggerto be manually shifted out of engagement with the firing bar and intoengagement with the knife bar after the firing stroke.Example 42—The surgical stapler of Example 37, wherein the firing systemfurther comprises a firing trigger, wherein the firing bar is driventoward the end effector during a first actuation of the firing trigger,and wherein the knife bar is driven toward the end effector during asecond actuation of the firing trigger.Example 43—The surgical stapler of Example 37, wherein the firing systemfurther comprises a firing trigger operably engaged with the firing bar,wherein an actuation of the firing trigger moves the firing bar throughthe firing stroke, and a cutting trigger operably engaged with the knifebar, wherein an actuation of the cutting trigger moves the knife barthrough the cutting stroke.Example 44—The surgical stapler of Examples 22, 23, 24, 25, 26, 27, 28,29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, or 43, whereinthe firing system is further configured to pause the operation of thesurgical stapler after the firing stroke is completed so as to permitthe user of the surgical stapler to optionally elect whether to performthe cutting stroke with the surgical stapler:Example 45—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft comprising a first jaw, a second jaw,wherein one of the first jaw and the second jaw is movable relative tothe other of the first jaw, a cartridge body including staple cavities,staples removably stored in the staple cavities, and an anvil configuredto deform the staples. The surgical stapler further comprises a firingbar configured to eject the staples from the staple cavities during afiring stroke, a knife bar configured to cut the tissue during a cuttingstroke, a firing trigger operably engaged with the firing bar, whereinan actuation of the firing trigger moves the firing bar through thefiring stroke, and a cutting trigger operably engaged with the knifebar, wherein an actuation of the cutting trigger moves the knife barthrough the cutting stroke.Example 46—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft comprising a first jaw, a second jaw,wherein one of the first jaw and the second jaw is movable relative tothe other of the first jaw, a cartridge body including staple cavities,staples removably stored in the staple cavities, and an anvil configuredto deform the staples. The surgical stapler further comprises a firingsystem configured to eject the staples from the staple cavities towardthe anvil during a firing stroke, a cutting system configured to cut thetissue during a cutting stroke, and means for preventing the cuttingsystem from performing the cutting stroke until the firing system hascompleted the firing stroke.Example 47—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft. The end effector comprises a firstjaw, a second jaw, wherein one of the first jaw and the second jaw ismovable relative to the other of the first jaw, a cartridge bodyincluding staple cavities, staples removably stored in the staplecavities, and an anvil configured to deform the staples. The surgicalstapler further comprises a firing system configured to eject thestaples from the staple cavities toward the anvil during a firing strokeand cut the tissue during a cutting stroke after the firing stroke hasbeen completed, and means for permitting the user of the surgicalinstrument to elect whether to perform the cutting stroke with thesurgical stapler after the firing stroke.Example 48—The surgical stapler of Example 47, further comprisingfeedback means for indicating when the firing stroke has been completed.Example 49—The surgical stapler of Examples 47 or 48, further comprisingfeedback means for indicating when the firing system is nearing the endof the firing stroke.Example 50—The surgical stapler of Examples 47, 48, or 49, furthercomprising feedback means for indicating when the cutting stroke hasbeen completed.Example 51—The surgical stapler of Examples 47, 48, 49, or 50, furthercomprising feedback means for indicating when the firing system isnearing the end of the cutting stroke.Example 52—The surgical stapler of Examples 47, 48, 49, 50, or 51,further comprising a visual indicator bar including a first range and asecond range, wherein the first range demonstrates the progression ofthe firing stroke and the second range demonstrates the progression ofthe cutting stroke.Example 53—The surgical stapler of Examples 47, 48, 49, 50, 51, or 52,wherein the means comprises a stop configured to stop the firing systemafter the firing stroke, and wherein the stop is selectively releasableby the user of the surgical stapler.Example 54—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft comprising a first jaw, a second jaw,wherein one of the first jaw and the second jaw is movable relative tothe other of the first jaw, a cartridge body including staple cavities,staples removably stored in the staple cavities, and an anvil configuredto deform the staples. The surgical stapler further comprises a firingsystem configured to eject the staples from the staple cavities towardthe anvil during a firing stroke, a cutting system configured to cut thetissue during a cutting stroke after the firing stroke has beencompleted, and means for pausing the surgical stapler to allow the userof the surgical stapler to elect whether or not to perform the cuttingstroke with the surgical stapler.Example 55—The surgical stapler of Example 54, further comprisingfeedback means for indicating when the firing stroke has been completed.Example 56—The surgical stapler of Examples 54 or 55, further comprisingfeedback means for indicating when the firing system is nearing the endof the firing stroke.Example 57—The surgical stapler of Examples 54, 55, or 56, furthercomprising feedback means for indicating when the cutting stroke hasbeen completed.Example 58—The surgical stapler of Examples 54, 55, 56, or 57, furthercomprising feedback means for indicating when the cutting system isnearing the end of the cutting stroke.Example 59—The surgical stapler of Examples 54, 55, 56, 57, or 58,further comprising a visual indicator bar including a first range and asecond range, wherein the first range demonstrates the progression ofthe firing stroke and the second range demonstrates the progression ofthe cutting stroke.Example 60—The surgical stapler of Examples 54, 55, 56, 57, 58, or 59,wherein the firing system comprises a firing trigger, a firing baroperably engaged with the firing trigger, wherein an actuation of thefiring trigger advances the firing member toward the end effector duringthe firing stroke, and a tactile feedback generator engaged with thefiring bar.Example 61—The surgical stapler of Example 60, wherein the tactilefeedback generator is configured to generate a series of sounds whichbecome increasingly louder as the firing stroke progresses.Example 62—The surgical stapler of Examples 60 or 61, wherein thetactile feedback generator is silent during a first portion of thefiring stroke and audible during a second portion of the firing stroke.Example 63—The surgical stapler of Examples 60, 61, or 62, wherein thetactile feedback generator is configured to generate a series of soundsat a rate which increases as the firing stroke progresses.Example 64—The surgical stapler of Examples 60, 61, 62, or 63, whereinthe tactile feedback generator generates haptic feedback when the firingbar reaches the end of its firing stroke.Example 65—The surgical stapler of Examples 54, 55, 56, 57, 58, 59, 60,61, 62, 63, or 64, wherein the means comprises a stop configured to stopthe firing system after the firing stroke, and wherein the stop isselectively releasable by the user of the surgical stapler.Example 66—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft comprising a first jaw, a second jaw,wherein one of the first jaw and the second jaw is movable relative tothe other of the first jaw, a cartridge body including staple cavities,staples removably stored in the staple cavities, and an anvil configuredto deform the staples. The surgical stapler further comprises a firingsystem configured to eject the staples from the staple cavities towardthe anvil during a firing stroke, a cutting system configured to cut thetissue during a cutting stroke after the firing stroke has beencompleted, and a feedback generator configured to indicate a shiftbetween the firing stroke and the cutting stroke.Example 67—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft, wherein the end effector isconfigurable in an open configuration and a closed configuration. Theend effector comprises a first jaw, a second jaw, wherein the second jawis movable toward the first jaw to place the end effector in the closedconfiguration, a cartridge body including staple cavities, staplesremovably stored in the staple cavities, and an anvil configured todeform the staples. The surgical stapler further comprises a closuresystem configured to move the second jaw toward the first jaw, and afiring system comprising a staple driver, wherein the firing system isconfigured to push the staple driver toward the anvil during a firingstroke and retract the staple driver during a retraction stroke, and acutting member configured to cut the tissue during a cutting stroke,wherein the cutting member comprises a cutting edge which is exposedfrom the cartridge body during the cutting stroke. The surgical staplerfurther comprises a lockout configured to prevent the staple driver frombeing retracted during the firing stroke and a bypass configured toovercome the lockout such that the staple driver can be retracted duringthe firing stroke.Example 68—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft, wherein the end effector isconfigurable in an open configuration and a closed configuration. Theend effector comprises a first jaw, a second jaw, wherein the second jawis movable toward the first jaw to place the end effector in the closedconfiguration, a cartridge body including staple cavities, staplesremovably stored in the staple cavities, and an anvil configured todeform the staples. The surgical stapler further comprises a closuresystem configured to move the second jaw toward the first jaw, and afiring system comprising a staple driver, wherein the firing system isconfigured to push the staple driver toward the anvil during a firingstroke and retract the staple driver during a retraction stroke, and acutting member configured to cut the tissue during a cutting stroke,wherein the cutting member comprises a cutting edge which is exposedfrom the cartridge body during the cutting stroke. The surgical staplerfurther comprises a lock configured to prevent the staple driver frombeing retracted prior to the completion of the cutting stroke and abypass configured to overcome the lock such that the staple driver canbe retracted prior to the completion of the cutting stroke.Example 69—A surgical stapler for treating the tissue of a patientcomprising a handle, a shaft extending from the handle, and an endeffector extending from the shaft, wherein the end effector isconfigurable in an open configuration and a closed configuration. Theend effector comprises a first jaw, a second jaw, wherein the second jawis movable toward the first jaw to place the end effector in the closedconfiguration, a cartridge body including staple cavities, staplesremovably stored in the staple cavities, and an anvil configured todeform the staples. The surgical stapler further comprises a closuresystem configured to move the second jaw toward the first jaw and afiring system comprising a staple driver, wherein the firing system isconfigured to push the staple driver toward the anvil during a firingstroke and retract the staple driver during a retraction stroke, and acutting member configured to cut the tissue during a cutting stroke,wherein the cutting member comprises a cutting edge which is exposedfrom the cartridge body during the cutting stroke. The surgical staplerfurther comprises a lockout configured to prevent the cutting memberfrom being retracted during the cutting stroke and a bypass configuredto overcome the lockout such that the cutting member can be retractedduring the cutting stroke.

The entire disclosures of:

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U.S. patent application Ser. No. 13/524,049, entitled ARTICULATABLESURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, filed on Jun. 15, 2012;now U.S. Patent Application Publication No. 2013/0334278;

U.S. patent application Ser. No. 13/800,025, entitled STAPLE CARTRIDGETISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013, now U.S. PatentApplication Publication No. 2014/0263551;

U.S. patent application Ser. No. 13/800,067, entitled STAPLE CARTRIDGETISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013, now U.S. PatentApplication Publication No. 2014/0263552;

U.S. Patent Application Publication No. 2007/0175955, entitled SURGICALCUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM,filed Jan. 31, 2006; and

U.S. Patent Application Publication No. 2010/0264194, entitled SURGICALSTAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, filed Apr. 22,2010, now U.S. Pat. No. 8,308,040, are hereby incorporated by referenceherein.

Although the various embodiments of the devices have been describedherein in connection with certain disclosed embodiments, manymodifications and variations to those embodiments may be implemented.Also, where materials are disclosed for certain components, othermaterials may be used. Furthermore, according to various embodiments, asingle component may be replaced by multiple components, and multiplecomponents may be replaced by a single component, to perform a givenfunction or functions. The foregoing description and following claimsare intended to cover all such modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

By way of example only, aspects described herein may be processed beforesurgery. First, a new or used instrument may be obtained and whennecessary cleaned. The instrument may then be sterilized. In onesterilization technique, the instrument is placed in a closed and sealedcontainer, such as a plastic or TYVEK bag. The container and instrumentmay then be placed in a field of radiation that can penetrate thecontainer, such as gamma radiation, x-rays, or high-energy electrons.The radiation may kill bacteria on the instrument and in the container.The sterilized instrument may then be stored in the sterile container.The sealed container may keep the instrument sterile until it is openedin a medical facility. A device also may be sterilized using any othertechnique known in the art, including but not limited to beta or gammaradiation, ethylene oxide, plasma peroxide, or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

1. A surgical stapler for treating the tissue of a patient, comprising:a handle; a shaft extending from said handle; an end effector extendingfrom said shaft, comprising: a first jaw; a second jaw, wherein one ofsaid first jaw and said second jaw is movable relative to the other ofsaid first jaw; a cartridge body including staple cavities; staplesremovably stored in said staple cavities; and an anvil configured todeform said staples; and a firing system configured to: eject saidstaples from said staple cavities toward said anvil during a firingstroke; and cut the tissue during a cutting stroke after said firingstroke has been completed.
 2. The surgical stapler of claim 1, whereinsaid firing system comprises a firing bar, and wherein said firing baris movable toward said end effector to perform said firing stroke andsaid cutting stroke.
 3. The surgical stapler of claim 2, furthercomprising a stop configured to stop said firing bar after said firingstroke.
 4. The surgical stapler of claim 3, wherein said stop ismanually-actuatable to release said firing member such that the firingmember can perform said cutting stroke.
 5. The surgical stapler of claim2, wherein said firing system further comprises: a staple driverconfigured to eject said staples from said staple cavities; and acutting member configured to cut the tissue, wherein said cutting membermoves with said staple driver during said firing stroke, and whereinsaid cutting member does not cut the tissue during said firing stroke.6. The surgical stapler of claim 5, wherein said cutting member iscoupled to said staple driver during said firing stroke, and whereinsaid cutting member is uncoupled from said staple driver during saidcutting stroke.
 7. The surgical stapler of claim 6, further comprising aclamp which releasably holds said cutting member to said staple driverduring said firing stroke of said firing member, wherein said clamp isconfigured to release said cutting member from said staple driver when aforce transmitted through said firing member exceeds a threshold force.8. The surgical stapler of claim 6, further comprising: a clamp whichreleasably holds said staple driver to said cutting member during saidfiring stroke of said firing member; and a clamp restraint configured toreleasably hold said clamp in a clamped state during said firing strokeand allow said clamp to bias open to disengage said firing member fromsaid firing bar during said cutting stroke.
 9. The surgical stapler ofclaim 1, wherein said handle comprises a firing trigger operably coupledwith said firing member, wherein said firing trigger is rotatablethrough a first range of motion and a second range of motion, whereinsaid firing trigger moves said firing member through said firing strokewhen said firing trigger is moved through said first range of motion,and wherein said trigger moves said firing member through said cuttingstroke when said firing trigger is moved through said second range ofmotion.
 10. The surgical stapler of claim 9, wherein said first range ofmotion is discrete with respect to said second range of motion.
 11. Thesurgical stapler of claim 10, wherein said first range of motion andsaid second range of motion occur during a single actuation of saidfiring trigger.
 12. The surgical stapler of claim 9, further comprisingan indicator configured to provide a first indication when said firingstroke has been completed and a second indication when said cuttingstroke has been completed, and wherein said first indication isdifferent than said second indication.
 13. The surgical stapler of claim12, wherein said first indication comprises one of a visual indication,an auditory indication, and a haptic indication, and wherein said secondindication comprises one of a visual indication, an auditory indication,and a haptic indication.
 14. The surgical stapler of claim 9, whereinsaid first range of motion occurs during one actuation of said firingtrigger, and wherein said second range of motion occurs during anotheractuation of said firing trigger.
 15. The surgical stapler of claim 9,further comprising an indicator configured to provide a first indicationwhen said one actuation of said firing trigger has been completed and asecond indication when said another actuation of said firing trigger hasbeen completed, and wherein said first indication is different than saidsecond indication.
 16. The surgical stapler of claim 1, wherein saidfiring system comprises: a firing bar configured to eject said staplesfrom said staple cavities during said firing stroke; and a knife barconfigured to cut the tissue during said cutting stroke.
 17. Thesurgical stapler of claim 16, wherein said firing system furthercomprises a firing trigger, wherein said firing bar is driven towardsaid end effector during an actuation of said firing trigger, andwherein said knife bar is driven toward said end effector during saidactuation of said firing trigger.
 18. The surgical stapler of claim 17,wherein said firing trigger is shiftable between a first position inwhich said firing trigger is operably engaged with said firing bar and asecond position in which said firing trigger is operably engaged withsaid knife bar.
 19. The surgical stapler of claim 17, further comprisinga switching mechanism configured to automatically shift said firingtrigger out of engagement with said firing bar and into engagement withsaid knife bar after said firing stroke.
 20. The surgical stapler ofclaim 17, further comprising a switching mechanism configured to permitsaid firing trigger to be manually shifted out of engagement with saidfiring bar and into engagement with said knife bar after said firingstroke. 21-25. (canceled)